


Nobody Knows Where They Might End Up

by deanlovescastielkisses



Category: Supernatural
Genre: Alternate Universe - Medical, Angst, Bottom Castiel, Domestic Violence, Eventual Happy Ending, Explicit Sexual Content, Frottage, Hurt Dean, Hurt/Comfort, M/M, Minor Character Death, Post-Traumatic Stress Disorder - PTSD, Psychological Trauma, Slow Build, Therapy, Top Dean, suicide attempt in a minor character
Language: English
Status: In-Progress
Published: 2014-12-04
Updated: 2015-06-15
Packaged: 2018-02-28 03:13:14
Rating: Explicit
Warnings: No Archive Warnings Apply
Chapters: 17
Words: 36,537
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/2716778
Author URL: https://archiveofourown.org/users/deanlovescastielkisses/pseuds/deanlovescastielkisses
Summary: <blockquote class="userstuff">
              <p>Castiel Novak is a surgical intern at Lawrence Grace Hospital looking to be the best that he can be. He meets Sam Winchester, who is also an intern, and they become instant best friends. They eventually establish residency and are on their way to becoming attendings.</p><p>Castiel's life, both personally and professionally, is greatly effected when a mysterious soldier comes into the hospital and helps them with a case.</p>
            </blockquote>





	1. A Hard Day's Night

**Author's Note:**

> This AU is based off of one of my other favorite shows: Grey's Anatomy.
> 
> Dean is based off of Owen Hunt and Cas is based off of Cristina Yang. These characters are not mine and they belong to the creator of Grey's, Shonda Rhimes and, of course, Eric Kripke.
> 
> 100% of the medical dialogue comes straight from the show since I know absolutely nothing about that kind of stuff.
> 
> I basically took season 5 and on from Grey's and rewrote it, changing minor things. 
> 
> If you have seen the show before, then this would probably bore you or something. But if you've never seen the show, then yay! But you should also watch it cause it's hella good.
> 
> I am NOT claiming to have come up with any of this on my own. ALL CREDIT GOES TO SHONDA RHIMES BECAUSE SHE'S A GENIUS.
> 
> I really like Owen and Cristina's story and I thought that writing a Destiel version of it could be fun.
> 
> Enjoy! Feel free to leave comments telling me what you think! :)

“A month ago, you were in med school, being taught by doctors. Today, you are the doctors. The seven years you spend here at Lawrence Grace as a surgical resident will be the best and worst years of your life. Look around you. Say hello to your competition. You will be pushed to the breaking point. Eight of you will switch to an easier specialty. Five of you will crack under the pressure. Two of you will be asked to leave. This is you starting line. This is your arena. How well you play? Well, that’s up to you.”

–Chief of Surgery, Bobby Singer

 

* * *

 

Castiel Novak has worked hard to be where he’s at today. He has a Ph. D in biochemistry and he’s obtained his M.D. from Stanford, graduating first in his class. He’s beginning his first day as a surgical intern at Lawrence Grace Hospital. He changes into his light-blue scrubs for the first time and couldn’t be more excited.

“You’re Castiel…umm..Novak, right? My name is Sam Winchester.” He stands up and holds his hand out.

Cas takes Sam’s hand and shakes it. “Which resident did you get? I’ve been assigned to Harvelle.”

“Ellen Harvelle? Yeah, me too.” He stands up and walks with Cas out into the hallway to find their resident.

A redheaded woman pushes herself in the front of the group to quickly introduce herself to Ellen. “Hi! My name is Charlie Bradbury! I’m so-“ Ellen cuts her off, “I have five rules. Memorize them. Rule number one: don’t bother sucking up. I already hate you. That isn’t gonna change.” She turns and points, “Trauma protocol, phone list, pagers-nurses will page you. You answer every page at a run-that’s rule number two! Your first shift starts now and lasts 48 hours.” She turns and begins walking down the hallway with her interns straggling behind. “You’re interns. Grunts. Nobodies. Bottom of the surgical food chain. You will run labs, write orders, work every second until you drop!” She leads them to a door and opens it. Inside there are rows of bunk beds. “On-call rooms-attendings hog them. Sleep when you can, wherever you can. Which brings me to rule number three. If I’m sleeping, don’t wake me unless your patient is actually dying. Rule number four: the dying patient better not be dead when I get there. Not only would you have killed someone, but you would have woken me for no good reason. We clear?”

Sam raises his hand. “You said five rules. That was only four.”

Ellen stares back at him and her pager goes off. She checks it. “Rule number five: when I move, you move.” She begins running down the hall and her interns follow.

A 15-year-old patient who suffers from having repetitive seizures in brought in. Harvelle and her interns are working her case. “Novak, you’re on labs. Charlie, patient work-ups. And Sam, get her for a C.T. She’s your responsibility now.” She turns and walks out of the room.

Sam wheels the patient through the hospital, but he appears to be going around in circles.

“You’re lost.” The patient, Katie, laughs.

“I’m not lost. How are you feeling?”

“How do you think I’m feeling? I’m missing my pageant.”

“You’re missing your pageant?” He smiles.

“The Lawrence Teen Miss. I was in the Top 10 after the first 2 rounds. This could’ve been my year!”

“Mhmm.” Sam smiles at Katie.

“I twisted my ankle in talent rehearsal. I do rhythmic gymnastics, which is, like, really cool. And I tripped over my ribbon. And I didn’t get stuck with someone as clueless as you.”

Sam rolls his eyes and finally gets Katie to C.T.

 

* * *

 

It’s lunchtime, and Cas is sitting by himself. Sam plops next to him and sighs. “My patient is a pain in the ass. If I hadn’t taken the Hippocratic Oath, I would Kevorkian her with my bare hands.” Cas just stares at him. They eat the rest of their lunch in silence.

Later on, Sam goes in to check on Katie and her parents are there, flooding him with questions that he can’t answer. He leaves to go get Ellen. “Katie’s parents have questions. Do you talk to them or-“

“Umm. No. She’s Dr. Jessica Moore’s patient now. Go talk to her. She’s our neurosurgeon.” She gestures over to a group of doctors and Sam can’t help but smile at the cute, blond doctor he sees.

Dr. Moore makes eye contact with him and walks over. “Are you the intern on my case?”

“Uhh. Yeah. Umm.” He fumbles with Katie’s chart as he hands it over.

She smiles as she takes it. “Alright, then. I guess I’ll see you around Dr. Winchester.” She goes off to check on Katie.

Later that day, Dr. Moore brings together all of the interns. “Okay, ladies and gentlemen. Katie needs surgery. The first intern to figure out why she is having multiple seizures gets to ride with me. You’ll get to do what no other interns get to do-scrub in to assist on an advanced procedure. Dr. Harvelle is going to hand you all a copy of her chart. The clock is ticking fast. If we’re going to save her life, it’s gotta be soon.”

Cas finds Sam and approaches him, “Hey. I want in on Moore’s surgery. You’ve been the intern on Katie since the start. You want to work together? If we find the answer, we’ll have a 50-50 chance of scrubbing in.”

“Yeah, sounds good. Let’s do this.” He flashes Cas a smile.

He returns it.

They make their way to the archives and plop down on the floor with a mountain of books and files beside them.

“So she doesn’t have anoxia, chronic renal failure, or acidosis. It’s not a tumor, because her C.T. is clean.”

“Hey, so what do you think of Jessica Moore?”

“What?”

“Yeah, she seems pretty awesome, right?”

“Sam, she’s just like any other doctor here.”

“No, she’s not. I’m thinking about asking her out.”

“You’re crazy! She’s an attending and you’re an intern.”

“So?”

“Alright. Clearly, having this discussion with you will neither help nor hinder you from asking her out. You seem like you’re smart enough to calculate the risks of asking her out, so I’m going to leave you to make that decision on your own.” He clears his throat. “We should really focus on Katie right now. Could it be an aneurysm?”

“Thanks, man.” He smiles. “Umm. There’s no blood on her C.T. and no headaches.”

“Okay, there’s no drug use, no pregnancy, no trauma.”

Sam sighs as he stands up to put a file back. “We’re out of answers. What if no one comes up with anything?”

“You mean, what if she dies?”

“Yeah."

“This is going to sound really bad, but I really wanted that surgery.”

“She’s just never gonna get the chance to turn into a person. The sum total of her existence will be almost winning Miss-Teen-Whatever. You know what her pageant talent is?”

“They have talent?”

“Rhythmic gymnastics.”

Cas laughs, “Oh, come on.”

They sit there laughing for a minute or so until Sam realizes something.

“What? Sam, what?”

“Get up. Come on.” He holds out his hand to help Cas stand up.

Cas stands up and they run to find Dr. Moore.

“Dr. Moore! Just one moment!” Cas calls out to her.

She turns around, “Yes?”

“Umm. Katie competes in beauty pageants.” Sam begins.

“I know that.”

“She has no headaches, no neck pain, her C.T. is clean. There’s no medical proof of an aneurysm, but what if she has one anyway?”

“There are no indicators.”

“She twisted her ankle a few weeks ago practicing for the pageant. She fell when she twisted it. It was no big deal, not even a bump on the head. She got right back up, and everything was fine. It was a fall so minor that her doctor didn’t even think to mention it when Cas was taking her history. But she did fall.”

“Well, you know what the chances are that a minor fall could burst an aneurysm? One in a million.” She pauses. “Let’s go see if Katie is one in a million.” She walks away and Sam hurriedly follows after her. Cas just shakes his head and does the same.

They run another test and it confirmed that Katie is bleeding into her brain.

“I’ll be damned. It’s minute, but it’s there. It’s a subarachnoid hemorrhage. Excellent work, you two. Dr. Novak, would you like to scrub in with me?”

“Uhh..” he shoots a quick glance over to Sam, who looks like his puppy was just ran over. “Umm. Dr. Winchester, here, should actually get to scrub in. He’s the one who made the discovery.”

Sam looks over at Cas, shocked.

“Very well. Dr. Winchester? Looks like you’re scrubbing in with me. We’re going in right away.” She smiles at him and walks away.

Sam looks over at Cas, “Dude. Why did you do that?”

He shrugs. “Well, like I said, you’re the one who figured it out. It’s only fair that you get the reward. Don’t worry about me. There will be other surgeries.” He pats Sam on the shoulder. “Now, go. She’s waiting for you.” Sam smiles and runs off to his first surgery.

**Notes for the Chapter:**

> So, I used this first chapter to establish that Cas and Sam are best friends and how that came about.


	2. Dream A Little Dream Of Me

Three years later, with more than enough of their fair shares of good and bad times, Sam and Cas find themselves as second-year residents at the hospital. Things are going pretty good for them.

Sam married Jessica exactly two years after their first surgery together, with Cas by his side as his best-man. Sam was so excited that their patient, Katie, survived the surgery and was no longer having seizures, he had the guts to ask out Jessica, who was more than excited to accept.

Sam gave Cas a bunch of crap about how there’s no problem with an intern being with an attending.

Seeing Sam and Jess’ happiness, Cas had hoped that he could find the same.

He dated one of the cardiothoracic attendings for a few months, and was even engaged to him. He feels like he dodged a bullet, though, when his fiancée didn’t even show up for their wedding. Sam says that he will find someone, but he doesn’t have the courage to give his heart to anyone else anytime soon.

 

* * *

 

It’s raining, which normally isn’t something that means a lot around here, but this rainy day, however, happens to be one of the worst. The fact that the temperature has been hovering right around freezing doesn’t help much either. Flash flood warnings are in effect all over the city and car crash victim after car crash victim are being brought into the hospital.

Bobby, Ellen, and Cas all find themselves standing in the trauma bay, waiting for three ambulances that are bringing in 3 separate victims from a car crash.

They pull in and Bobby rushes to the first ambulances and opens it up. “Novak! Come with me. What do you got?”

“58 year old male, M.V.C., tachy and 160, B.P. 80 palp, decreased bilateral and breath sounds.”

Something isn’t quite right with this. Not only is the victim unable to breathe, but there’s a strange man in a camouflage uniform who is leaning over the patient and breathing into something that is sticking out of the patient’s neck.

“What the hell is this?” Bobby asks.

“I didn’t do it. He did!” The EMT points at the soldier, who is still breathing into the tube. “G.I. Joe trached him in the field before I got there!”

“With a pen? You trached this guy with a pen?!”

The soldier stops breathing into the pen and looks up at Bobby with a pissed-off expression. “So?” He leans back in and continues to breathe into the pen. It was brief, but Castiel was able to catch a quick glimpse of the soldier’s intensely green eyes. Those eyes, plus the level of badass-ness radiating from the soldier, put Cas in a sort of trance and he just stands there, shocked with the sequence of events that are unfolding in front of him.

“Move this guy inside, now. Come on. Let’s go.” Bobby orders. They roll the victim inside and Cas snaps out of it, quickly following the group of EMTs and Bobby and the soldier into the hospital.

“You trached a man in the field with a ballpoint pen?!” Dr. Benny Lafitte asks. Benny was hired by the hospital a few years ago as the plastic surgeon attending.

“That’s all I had on me.” The soldier shurgs.

Benny shakes his head as he continues to work on the patient.

“What? It’s not like I didn’t clean it off first.”

“I think it’s awesome.” Jo smiles as she helps with the patient. Jo is also a second-year resident with Sam and Cas.

Dean walks over to check on the work that Benny is doing. “Really? You’re going with a size 6 shiley tube on that?”

Benny scoffs, “Somebody get this guy away from me.”

“I’m gonna need a C.T. of this belly, Chief.” Ellen looks over at Jo. “Jo, honey, get us in line for that.”

“Looks like his trachea is crushed. I’m gonna need an O.R. and an extra set of hands. Who’s available?” Benny asks Ellen.

“Winchester.” She responds.

“Hmm?” The soldier looks up at Ellen.

“Uhh. Sam Winchester. He’s available.” She responds. Benny nods and walks out of the room.

“Wait. Sam? Sam Winchester works here?” He runs a hand through his hair.

“Yeah, why? What’s it to you?”

“Oh, nothing. It’s just, uh, we go way back.”

“You’re related to him?”

“What? No!”

“Boy, you must take me for a fool. Your uniform says Winchester on it. So what is it? Cousin? Brother?”

He sighs, “He’s my little brother.”

“Something tells me that you ain’t too excited to hear that he works here.”

“No, it’s not that. It’s just-“

“Ellen! Come on, we got an O.R. Let’s take him up.” Benny interrupts and Ellen pushes the patient out of the trauma room, leaving the soldier standing alone in the room.

Bobby walks in, “You’re bleeding, son.”

He looks down at his thigh, “Yeah, my car was right behind theirs at the intersection. I cut it on impact.”

Cas walks into the room, waiting for Bobby.

“And you triaged these men?” Bobby asks.

“Major Dean Winchester, U.S. Army, second forward surgical. I’m a trauma surgeon. I just got home on leave.”

“Winchester, huh? Any relation to“

“Yeah, he’s my little brother. But, if you could, don’t tell him I’m here. I’ll…do it later.”

“Sure thing.” Bobby nods and turns towards Cas, “Dr. Novak, take care of Major Winchester’s leg.” Dean looks over at Cas and winks.

Cas is shocked. Like, more shocked than at any other time in his life. Sam has a brother? An older brother? A very attractive and amazingly brave and smart and talented older brother? He didn’t even realize that his mouth was hanging open until he tries to speak. He clears his throat to bring himself back to normal. It doesn’t help. “Uh, sir. I’m-I’m scrubbing in with you.” His voice is shaky but he doesn’t think that either of them noticed it.

“After you take care of Major Winchester, boy.” Bobby turns and walks away.

Cas sighs and turns to look at Dean, who is now walking away.

“Hey! Where are you going?”

“To check on my other patients.”

“Uh…” Cas hurries and steps in front of Dean. “You are the patient. Now, come on, let’s fix your leg and then we can check on the other patients.” Cas leads Dean to an examination room and begins to prep Dean for staples to close up his cut.

After assessing the damage and cleaning it up a little bit, Cas gets up and turns around for a few seconds, and Dean grabs the stapler and begins stapling his leg back together.

Cas turns back to Dean, “Woah! What are you doing? You’re not numbed!”  
Dean looks up at Cas, “So?” He staples a few more and pauses. He looks back up at Cas and hands him the stapler, “Can you get the rest? I can’t reach.” He chuckles.

Cas, confused, takes the stapler and staples the rest of Dean’s cut back together.

After the last stapler is inserted, Cas laughs and stands up.

“Thank you.” He flashes a smile.

“You’re welcome.”

He and Dean lock eyes for a couple seconds until Gabriel comes barging in. “Can I ask you something, Cas?”

Cas, shaken from the trance that Dean has been able to put him under, looks over at Gabriel, slightly annoyed, “Uh..w-what?” He clears his throat.

“I need to ask you something, but I can see that you’re busy so I’ll just come back later.” He winks.

“Yes, you’re right. I am busy. I have surgery to get to.” He looks over at Dean, “Clean yourself up.” He smiles and walks out the door, Dean watching him as he leaves.

 

* * *

 

Dean wanders the halls looking to check up on “his” patients. He turns a corner and sees Sam.

“Shit.” He whispers as he tries to back up around the corner, but he ends up knocking over a shelf of supplies, making a huge noise.

Sam looks up and sees Dean fumbling with the supplies. “What the-“ he starts as he walks over to Dean. “Dean?!”

Dean looks up, “Sammy! Hey! There you are!” He’s obviously using his fake-over-excited voice.

“Dean? What the hell are you doing here?!”

“I’m, uh...on leave…right now. I was in an M.V.C. with a few guys that were brought here.”

“And you didn’t think to call me and tell me that you’re home?! How long have you been home? Jesus, Dean, we didn’t even know that you were coming home!”

“Yeah, well-“

“You need to call mom right now.”

“No.”

“Yes. Right now, Dean.”

“Dammit, Sam! I said no!”

“Why, not? You know that she worries about you constantly!”

“I just…I can’t, okay? Please? I’m going back to finish my tour in a few days. Just let me go.”

“Dude. What’s happened to you? Don’t you care about how she feels?”

“Of course, I care! What kind of a fucking question is that?!”

“Well, why aren’t you acting like you do?”

“Sam. Please.”

Sam takes a deep breath, “Do you still call her every day?”

“Yeah. Every day. Just like I promised her.”

“She worries about-“

“I know.”

“I worry about-“

“I know. I know. I’m sorry. I just…I can’t go see mom. Not now.”

“Okay.”

Sam pulls his brother into a tight hug.

“I’ll be back in a few months.”

“Okay. Just…make sure you keep calling her, okay? And call me once in a while, you jerk!” He chuckles.

“Yeah, yeah, bitch. Take care of yourself, Sammy.” He smiles softly.

Sam smiles, “Dude, please stop calling me that.”

“Never.”

Dean turns around and walks away with a smile.

 

* * *

 

Cas, Sam, and Jess are all walking out of the hospital at the end of their day. Cas still can’t help but think about the badass soldier with piercing green eyes, who also happens to be one of the most beautiful humans he has ever laid eyes on, who _also_ manages to be his best friend's brother.

Sam catches him in a day dream, “Hello? Earth, to Castiel!”

Cas snaps out of it and notices that Sam and Jess are staring at him, smirking.

“What are you thinking about?” Jess asks.

“Umm….no one…uhh…nothing. I meant, nothing.” He clears his throat.

“You damn lair. Spill it.” Sam starts laughing.

“Umm…” His cheeks turn red and he starts rubbing the back of his head. “There’s, umm…someone I find rather attractive in the hospital right now. But, he’s leaving and never coming back so…” He trails off and shoves his hands in his pockets as he looks down at his feet.

“Who?” Jess asks, but Sam gives her a small nudge to not encourage Cas to talk about it.

“Umm…” he looks up at them. “Sam…please do not be angry with me...but, it's Dean.”

Jess squeaks in laughter because the look on Sam’s face right now is priceless. Cas cringes. Waiting for the punch to come flying even though he knows that Sam would never hurt him. He feels like he deserves it, though. He shouldn’t be developing a childish crush like this on his best friend’s brother.

Sam doesn’t say anything for a minute or so and neither Cas nor Jess try to pry anything from him. He has his ‘shut-the-hell-up-I’m-trying-to-figure-this-out-face’ on and Cas learned the hard way to never interrupt him in that mindset.

“You…you like my brother? Like, you like him, like him?”

“I was not aware that we are back in middle school, but no. It’s just a crush. A very minute one. He’s leaving soon and he’s your brother. It wouldn’t be right.”

“I think it would be right.” Jess chimes in with a smile and Sam glares at her.

“Whatever,” he sighs and throws his arm around Jess. “Let’s go to Joe’s. I need a drink.” They begin walking away.

Cas doesn’t move, though. He’s not quite sure where Sam stands on this whole subject and, thankfully, he’s not going to have to worry about it because he’s never going to see Dean again.

Sam looks over his shoulder, “You coming, Cas?”

“Yeah, uh, I’ll meet you guys there!” He calls back to them and turns to walk back in the hospital when, suddenly, he loses his footing and ends up slipping on some ice that has accumulated near the entrance and he falls straight on his back.

“Ahh…” he hisses as he rubs the back of his head.

He hears a soft sound of crackling coming from above his head. He looks up and notices that there is a row of very large and thick icicles hanging from the awning on the hospital. One of them breaks free and plummets down towards Cas, impaling his abdomen.

He gasps and clutches at the 10-inch icicle sticking out of his stomach.

He throws his head back on the ground and he tries to call out for help, but the shock that has set upon him from the situation prohibits him from doing so.

A face-that same beautiful face that he was just trying to convince himself that he wasn’t severely crushing on-is now looking down on him with pity.

“A damsel in distress.” He smiles and leans down to pick Cas up off the ground.

Cas grunts and groans from the pain, unable to stop Dean from picking him up.

Dean walks him inside the hospital and plops him down on a bed.

That's when Sam comes barging in, “Cas! What the hell?”

He groans from the pain and sighs, “What? How did you-“

“Since you weren’t coming, we came back to look for you and find you with an icicle impaled in your stomach. How the hell does that even happen?!”

“I fell.” He sits up and groans from the pain and Dean presses a firm hand down on his shoulder. “Nuh-uh. Stay down.”

“Put him on a monitor. Order a portable chest. I’m gonna cut your top off.” Sam moves in to work on Cas.

“It’s between my ninth and tenth intercostal spaces. There’s no hemo or pneumothorax. My vitals are stable. Just pull it out, Sam.”

“I wouldn’t.” Dean chimes in as he presses his stethoscope to Cas’ chest.

“Mind your own business.” Cas barks back at him and Dean puts his hands up in surrender.

Cas turns and grabs Sam’s shirt, “Pull this thing out of me, Sam.” He growls.

Bobby walks in the room. “What the hell happened, Novak?!”

Cas throws his head back and sighs.

“Get him on a monitor and order a portable chest.”

“I did.”

“Did you check his respiratory function-“

“I did.” Cas says. “See?” He inhales. “Breath sounds. Clear and equal.”

“You, be quiet.” Bobby orders. “Sam, what would you advise as a course of treatment?”

“I think we should leave it in until we get the chest x-ray and the C.T. back.”

“I’m fine.” Cas hisses at Sam.

“But what about infection, Cas? This thing is definitely melting dirty roof water into his body.”

“Which is why we should pull it out!”

“Leave it right where it is.” Dean commands. “You get stabbed in the chest and you’re lucky enough to still be breathing, you leave the knife in, at least until you figure out what’s going on internally. Leave it in.” He orders.

“Take it out!”

“Leave it in.” Bobby orders. “Can I get a word with you, Major Winchester?” He points to Dean as he walks out of the room and Dean follows.

Sam stays in the room with Cas and sits by his side. “You’re such an idiot, Cas.” He laughs and Cas can’t help but laugh at the situation he’s in as well.

Cas eventually convinces Sam to go back to Joe’s with Jess and insisted that this shouldn’t ruin the night. The scans and x-rays show that the icicle isn’t impaled on anything important internally, so they’re just waiting until it melts. As Sam walks out, Dean walks in. Sam shoots Dean a glare and it makes Cas giggle.

Dean walks over to Cas, quickly checking the x-ray himself. He leans down over Cas, looking into his eyes with a soft smile on his face.

“What-what are you doing?”

Dean doesn’t answer, he just continues staring at him. Cas can’t help but blush because Dean is in his personal space right now and Cas can’t get away from him.

Just as it seems like Dean is about to kiss Cas, he wraps his hand around the icicle and pulls it out.

Cas gasps and Dean moves his hand to press on the wound. Breathing heavily he looks at the object in Dean’s hand, “That’s my icicle…” he breathes.

“Yeah.”

“Uh, you took out my icicle.”

Dean nods as he rubs the wound.

“I didn’t give you permission to do that.”

“So?” He smiles.

He rolls Cas onto his side so he has an easier time with the sutures.

“Tell me about trauma surgery.” Cas says softly after a few minutes of silence.

“Trauma?” He scoffs. “Quick and dirty. There’s no time to make things pretty and no time for mistakes.” He finishes up Cas’ stitches. “Drop your pants, you need a shot of Cefazolin I.M.”

Cas sighs and pulls his pants down, slightly embarrassed. “No time for mistakes, huh? So what, you don’t make mistakes?”

“I make mistakes and people die.” He stabs Cas with the syringe.

Cas sighs, “I’m the best surgical resident in my program and…last week, I killed a man because I couldn’t do a stitch.”

“In the field, you do what you can…you work with what you have. It’s about something. It’s not about being the best. It’s about saving lives.” He sighs and sits down next to Cas. “I make mistakes. Guys die by my hand, good guys. Guys who are fighting for their country in a desert. And I don’t know everything. Nobody does. So, I make mistakes and I learn. And the next time, I don’t make that mistake again. So the next guy, that guy, he lives.” He smiles softly and nods his head at Cas, who can’t seem to respond. “Mistakes are how you learn, Cas.”

Cas rolls over in his bed so Dean can check on his sutures. He stands and everything seems to be looking good, and he applies an ointment to the area to help prevent infection. Cas looks up at him, smiling softly. He makes eye contact and Dean smiles. “You know, you’d be good in the field. Now that you got this battle scar, you’d fit right in.” He laughs and Cas smiles. “I’m serious. You should ditch this place and go for the adventure. You’re telling me this place gives you a rush, a high?”

Cas smiles and looks around, “Yeah. Yeah, it does.”

Bobby walks in, “Oh, Major Winchester, there you are.” He closes the door. “How’s the gash on your leg doing?”

“Uh, Dr. Novak took good care of me. Excellent care.” He looks back and smiles at Cas who is now sitting up in his bed.

“I made a few calls. They speak very highly of you at Maryland Shock Trauma. I also heard a story that you constructed an O.R. table from an exploded Humvee in the middle of the desert. That true?”

Dean nods, “Well, you have to be innovative in the middle of the desert.”

“You have to be innovative everywhere. How would you like a job, Dr. Winchester?”

Dean pauses. Not quite sure how to answer. He looks over at Cas who isn’t quite sure of what to think of Bobby’s offer either.

“Uhh…” he breaks the silence, “I appreciate the offer, but I am due to go back to the sandpit, finish my tour.”

Cas’ heart drops in his chest. Whether it be from relief or disappointment, he’s not sure.

“Well…good luck to you, son.” Bobby pats his shoulder and walks out of the room.

Dean turns and pulls the gloves he was wearing off his hands and throws them in the trash can. He then reaches up and closes the blinds on one of the windows in the room.

He looks over his shoulder at Cas, who is still sitting on the bed with his legs hanging over the side, facing Dean.

“What?” He asks. Before he can even react, Dean is kissing him. He runs a hand through Cas’ hair and moves his head to get a better angle on the kiss. They kiss for a few more seconds before Cas breaks from it, stammering, “I-I-I don’t even know you.”

“So?” He smiles. He runs an affectionate hand through Cas’ hair one last time before walking away.


	3. Life During Wartime

Cas hasn’t seen, heard of, or even thought about Dean for a few months, now. Sam hasn’t brought him up and Cas never thought to ask about him. Focusing on his job takes all of his time and energy and he really doesn’t have time to think about hot, army surgeons who pull out people’s icicles and kisses them passionately afterwards.

One morning, Bobby approaches Benny and Ellen, “Uh. I want you two to meet the new head of trauma at Seattle Grace, Major Dean Winchester. You remember him?”

“Yeah, you critiqued my techniques and assessments every time you had the opportunity.” Benny deadpans.

Dean laughs, “Well, now you get to critique mine.”

“Looking forward to it, brother.” They both laugh as they shake hands.

“I just talked to a friend of mine at the D.O.H. and now that we have Dean, we are being reclassified as a level one trauma unit by the end of this month.”

That means more traumas which means more patients. They couldn’t be more excited. Ever since being demoted to a level two trauma, things had been somewhat slow down in the Pit.

Sam and Cas are on their way to their morning rounds and Cas stops instantly in his tracks when he sees Dean standing in scrubs and a lab coat talking with the Chief.

He grabs Sam by the arm, “Run!” He turns around and pulls him as they run down the hall. They round a corner and stop running. Cas leans against the wall as Sam stares at him with a confused look. “Okay.” He pants. “What was that all about?”

“I just saw your brother.”

“Oh, yeah. He’s gonna work here now.” He smiles at Cas as if that was the most normal thing for him to say at this moment.

Cas glares at him, “And you didn’t even think to mention it to me?!”

“What’s the big deal? You said that you would get over your crush. It’s been a few months since you saw him. You’re over your crush, right?”

Cas doesn’t answer.

“Oh my-what the hell, Cas?”

“It’s not my fault! He pulled out my icicle and then he kissed me and then-“

“Hold on.” He hold up a hand. “Dean kissed you? Did you kiss back?!”

“What kind of question is that?”

“It’s the only question I can come up with that doesn’t involve me kicking your ass!”

“Sam! It wasn’t my fault!”

Sam sighs, calming down, “I know, Cas. I know.” He places a hand on his shoulder, “You okay, though?”

“I should be fine. It’s just going to be interesting to try and avoid him.”

“Why do you want to avoid him?”

“ _He_ kissed me!” He emphasizes. “It was nothing, though. I mean, it was a stupid, little nothing. But-”

“But you don’t think he thinks it was a stupid, little nothing.” Sam finishes for him.

“Well, I mean, he obviously likes me, and now he’s back. And I am not getting involved with another attending. What’s he doing back anyways?”

Sam doesn’t answer him, kind of avoiding having to answer that question. “Look man, just talk to him. I gotta go.” He runs off and Cas peeks around the corner to see if Dean is still there. He’s not, so he walks towards the resident’s lounge to change into his scrubs.

Bobby summons all of the residents and their interns together and tells them that they all are required to attend a skills lab. This particular skills lab is run by none other than Dean himself. Great.

Cas notices Dean walking into the room and he pulls one of his interns in front of him so he can hide.

“What are you-“ she complains.

“Just, be quiet and don’t move.” He whispers as he ducks behind her.

“Alright, I’m Dr. Winchester. And yes, that tall, dark and handsome giant over there…” he points at Sam who rolls his eyes, “…is my brother. So don’t bother asking. I’m tired of having to explain that one.” He clears his throat. “Over the next few months, I will be teaching you how to work quickly and efficiently to keep someone alive in circumstances where the safe bet is they’re dead by the end of the hour. Alright, let’s get started.”

Dean assigns each resident and their interns to different surgical mannequins and gives each of them a different scenario.

He finally gets to Cas and his interns, “You seem to be spending a lot of time on that anastomosis. What was your name again?”

Cas looks at Dean, confused, “Novak. Castiel Novak.”

“Right. Come take a look at this guy’s mannequin.” Dean leads Cas over to one of the younger residents who appears to be wrists-deep into his mannequin.

“Tran? You want me to take lessons from Kevin Tran?” Cas can’t help but feel a little hurt by Dean in more ways than one right now.

“Step aside. Make way for Dr. Novak.” Kevin instructs his interns.

“Okay. Now, you see what he did? He stopped the bleeding, and then he moved on to his liver lacerations.”

“Yes, but sloppy work can lead to complications. Two days from now, when this mannequin starts vomiting blood, Kevin is going to wish that he had been a little more thorough.”  
“He can come back later and make things pretty when his mannequin is stable. Meanwhile, your mannequin is getting acidotic and hypothermic. If this was some scrawny kid, he’d be dead by now. Quick and dirty, Casteel.”

Cas gives Dean a sour expression at the wrong pronunciation of his name. “-iel! Cast-iel!” He rolls his eyes as Dean walks away.

 

* * *

 

As the day goes on, each of the residents get called onto various cases. Leaving Cas and his interns behind to keep them all alive by themselves. Dean comes in a little while later to get an update from Cas.

“Number 1, here, is indestructible.” Cas starts. “He lost a part of his liver and small bowel, but he’s been doing fine. We had to cross-clamp Number 2’s aorta and massage the heart. I couldn’t locate the source of the bleeding until I found a hole in the diaphragm and realized he had a splenic laceration.” Cas walks down the line of mannequin’s with Dean and he’s quite impressed with what he’s hearing so far. “Number 3 had some oozing after his colon resection, but we packed it and he’s been stable ever since. Number 4 almost bled out because the carotid was sliced right through, but we put in a graft and he’s been stable ever since.” Cas looks back at his interns who are beaming with pride and Cas can’t help but do the same.

“That’s good. Great job, all of you. So, uh…clean up in here and make sure you write up your work.” Dean walks out of the room.

Cas gives his interns one look and they spring into action, quickly cleaning up their messes and Cas walks out to find Dean.

He finds him and grabs him by the arm, “Seriously, you don’t remember my name?”

“I remember your name. But that was before.” He pauses and shakes his head. "This last tour, I was on a forward surgical team. We uh...treated combat casualties in the field. You're mostly just looking to do damage control-sedate 'em, ventilate 'em, airlift 'em to Baghdad, then get outta there.” He pauses, “Only this one time, we didn't get out fast enough because we ended up in the middle of an RPG ambush. There were 20 people in my unit, including me, and 19 died. And then I got discharged. So...” he sighs, “I'm not there anymore. In the before. I knew your name in the before. But now I'm living in the after.” He walks away.

 

* * *

 

A week or so goes by with Dean being at the hospital and Cas is doing better than he thought he would. He only sees Dean once, maybe twice a day and they never talk about anything other than their patients.

Recently, Cas and Sam have stumbled upon various journals cataloguing surgical procedures performed by doctors from the hospital and they can’t stop reading them. Cas would call Sam in the middle of the night to talk about what he was reading and Sam would do the same. Jess has been getting the short-end of the deal, however, because she is losing sleep because of it. Sam sits in their bed and talks with Cas all night and she’s had enough.

She runs into Benny on an elevator and she came up with a plan. “I need you to have sex with Cas.”

Benny looks over at her with one eyebrow raised.

“Give him something to do after midnight that doesn’t involve him calling my husband and waking me up.”

“Novak?”

“Mmhmm.”

“No. He’s too serious. Humorless. Un-fun. Not my type.”

“Novak should be your type. He’s intense, intelligent, complicated. He’s like…” she pauses, “…a single-malt scotch, and you’re used to beer bongs.” She laughs.

“That’s not-“

“Oh, wait. I get it. You don’t think you have a shot. You’re probably right.” She plays.

“Oh, I have a shot.” He winks at her and walks off the elevator.

Jess sighs in contentment as the elevator doors close.

 

* * *

 

Dean is walking through the halls trying to find an on-call room to get some much needed rest. He’s been working for 3 days straight and Bobby threatened to fire him if he doesn’t get some sleep. As he rounds a corner, he bumps into a shorter man.

“Oh, shit. I’m sorry!” Dean mumbles.

“Woah, there! Take it easy! What’s the rush, friend?” He soothes.

“Uhh…I’m just trying to find a place to sleep.”

“Oh, yeah. I hear ya. So, you’re the new guy? I’ve heard a lot about you.”

“Yeah. Dean. Dean Winchester.” He holds out a hand.

“Dean-o! That’s what I’m gonna call ya. I’m Gabriel Milton. Orthopedics.” He winks as he shakes his hand.

Dean scoffs. “Whatever, man.” He smiles. “Nice to meet you.”

“Winchester!” Bobby calls from down the hall. “We got a trauma coming in. We’ll need you too, Gabriel!” He turns back towards the E.R. and walks away and Dean and Gabriel follow.

“Hold compressions. We got a rhythm.” Dean says as he continues working.

“We’ve gotta get him up to surgery. He’s bleeding through his leg splint.” Gabriel asses.

“So, the Chief asked me to watch all the second-year residents for the solo surgery. What’s your take, as a class?”

“They’re a mixed bag. Novak’s very good.” He looks up at Dean, gauging his reaction. “He’s hardcore. He’ll be a cardio god. He’s my roommate, actually. So that means we talk…” he pauses and Dean shifts his stance a bit, “…he tells me things. Things like, cute army doctors kissing him and whatnot. You know, the usual roommate convos that are had.” He smiles and Dean scoffs.

Cas walks in the trauma room and Dean walks over to him, “New scans. Good.”

Cas brings them up and points at it, “There’s a splenic subcapsular hematoma-“

“I can look.” Dean interrupts. “Go update his chart.”

Cas sighs and walks out of the room. Dean walks back over to the patient and Gabriel is raising an eyebrow at him. “Really?” He asks.

“What?” Dean snaps.

Gabriel smiles and shakes his head as he continues working on the patient.

Cas is waiting in the E.R. to get a consult from Benny.

“Dr. Novak. You paged me?” He walks over to Cas and leans against the desk Cas is sitting at.

“Yes, I did. Patient. Trauma one.”

“Oh, you paged me for a consult? I was hoping that you wanted to see me.” He smiles at Cas.

“I did. Uh, the patient has a shattered nose and cheekbones and a fractured left mandible. Trauma one.” He points and walks away. Obviously not picking up on Benny’s flirting.

Benny looks confused, but walks over towards the trauma room.

 

* * *

 

Sam is talking with Jo in the hallway and Cas approaches them.

“I am having, what you would call, a rough day. Please excuse us, Jo.” He grabs Sam by the arm and tugs him away.

“What happened?”

“Dean. Dean hates me. I mean, he hates me.”

Sam sighs. “But he kissed you, remember?”

“Yes! But, uh, that was, I don’t know, before. Now he hates my guts. I have no idea what I did or-or said or what.” His pager goes off and he checks it. “Damn it. That’s Dean.” He sighs. “I need to get off this case.” He turns and walks away and Benny approaches him.

“Ah, Dr. Novak. So nice to see you here.” He smiles. “Our guy is scheduled for surgery and I would like to know when I’m gonna see you next.”

“Uh…he’s not stable yet.” Cas is still looking down at his pager as it goes off a second time.

“Oh. Well, then we might have time to-“

“Uh, I just got paged down.” He walks away from Benny and he sighs.

Sam witnessed the whole thing and he can’t stop laughing. “Dude. Really? You’re trying to hit on Cas? You do realize that it’s like trying to hit on a brick wall, right?”

Benny doesn’t say anything as we walks away.

Dean, Cas, and Gabriel find themselves in surgery.

“Novak. Suction here, please.” Dean calls to him. “Lafitte’s coming in for the mandibular repair?”

“Yes.”

Gabriel clears his throat, “Sorry about before, Dean-o. Everybody’s business here is everyone else’s business.”

“Yeah, well. It’s better to keep things professional if you can.” He says while looking at Cas and Cas looks up at him with a confused expression.

Benny walks in, “Dr. Winchester, how’s our patient?”

“Still with us. He’s a fighter.” He continues working on the patient.

Benny walks over and stands next to Cas, “Dr. Novak, I know that cracking chests is more up your alley, but you would be surprised how exciting it can be when I manipulate a little skin.”

Gabriel and Dean both look at Benny with a confused look.

Dean looks over at Cas, “Actually, Dr. Novak. Why don’t you just scrub out? We’ve got enough hands in here.”  
Cas sighs and walks out of the O.R.

After the surgery, Cas and Jo are checking up on the patient to make sure that everything is going good.

“Vitals are stable for now.” He checks his urine output. “Was there this much blood in his urine before?”

“No. He’s gonna need a bedside cystogram. I call dibs on that.”

“You can’t just call dibs, Jo!”

“Yes, I can! And I just did!”

“No, it’s mine. And his bladder repair is mine, too.”

“No way!”

Dean looks over at the room and notices that Cas and Jo are arguing. “Get away from that man, right now!” He calls over to them as he walks into the room.

Cas and Jo look up at him like deer caught in headlights.

Cas is the first to speak, “He was crashing so we increased his dopamine and gave-“

“Are you deaf, Novak? I said get away from him.”

“I’m just saying that we were saving his life.”

“No, what you did was pick over him like vultures, like a bunch of kids fighting over toys. What you did was treat a man, who is fighting to live, like he’s already dead. You have no sense, no decency, and no respect!” He takes a deep breath, trying to calm himself. “Just get out. Both of you.”

Jo quickly leaves the room and Cas walks out slowly.

Dean brushes passed him and checks the patient’s pulse and Cas stands outside of the room staring at Dean as he works.

 

* * *

 

At the end of the day, as Cas is updating his patient’s chart Benny approaches him, “Dr. Novak.” He smiles. “I’ll need you to bring me the post-op report on our patient before you leave tonight.”

“I’m sorry.” He looks up at Benny. “Did you say something?”

“Novak. What is wrong with you?”

“I’m sorry?”

“I’ve had women opt for needless elective buttock enhancement surgery just for another chance to be flirted with by me. I’ve had men opt for needless pectoral implants just for another chance to be flirted with by me. So what is your problem?”

“I have no idea what you’re talking about.”

Benny stares at Cas, “I’ve been hitting on you all day!”

Cas laughs, “Oh. I…really?” He cringes as he stands up from the desk. “Excuse me.” He walks away laughing.

Benny tries to brush off his embarrassment, but fails, “It wasn’t even my idea! I was Jess’ idea!” He calls out to Cas but Cas didn’t care.

“Oh, come on.” Jess laughs.

“That man, right there, is not a single-malt scotch, my little blond friend. He is bad, cheap wine that gives you a headache you can feel in your teeth.

Dean overhears the whole conversation and grits his teeth as he walks away. He finds solitude in an on-call room.

A few minutes go by and Cas knocks on the door and walks in, “Our beating victim’s wife is here. She just identified him for us and she wanted to-“

“What’s his name?” Dean interrupts. “I wondered if you asked her what her husband’s name is so that way he could become a person to you. They’re all people, Novak. This is not a game or a contest or a competition to see who gets a surgery and who doesn’t. They’re people and we get to save them. Now, you’re good. You’re excellent at what you do. You could win all the contests, but if that’s why you’re doing this, then you shouldn’t be.” He pauses and Cas doesn’t respond. “So, did you find out his name?”

Instead of responding, Cas steps inside the room and closes the door behind him.

He sits across from Dean and takes a deep breath.

“My mother died when I was 9 in a car accident. I was with her in the car. While we waited for the ambulance, I tried to keep her chest closed so she wouldn’t bleed so much. When she died…my hands…” he looks down at his hands, “…felt her heart stop beating.” He looks back up at Dean, “That’s why I do this. It’s also why I win all the contests. The patient’s name is Tom.” He stands up and walks out of the room.

Dean is left sitting there, with a sense of amazement flowing through him. “Single-malt scotch.” He whispers to himself with a slight smile on his face.

When all the doctors go home, Cas goes with Sam over to their place. They sit on the couch with a couple of beers and some old medical journals opened in front of them.

“ _So I ended my day with segmental colectomy…_ ” Cas reads.

“Oh, badass!” Sam laughs as Jess walks in. He looks at her. “Benny? Really?” He and Cas erupt in laughter.

“What? Did you think we would double-date?” They both laugh.

“Look, I’m going to take my clothes off now.” Jess says with a smile.

“Then, I shall leave.” Cas quickly gets off the couch and heads for the door.

Sam laughs at how fast Cas was able to leave the room. “G’night, Cas!” He calls out to him.

Cas waves back to them and heads out the front door.

 


	4. These Ties That Bind

It’s early in the morning and Cas bursts into Sam and Jess’ room with cups of coffee in his hands.

Jess doesn’t even need to open her eyes to know that it’s Cas in their room. She mumbles under her breath and Sam leans over to kiss her cheek, “Sorry, babe. Cas is here.”

She groans as she pulls herself out of bed. She trudges passed Cas, who is standing at the foot of their bed waiting until she leaves so he can sit.

She approaches him and swipes one of the coffees from his hands.

He begins to protest, but Jess cuts him off, “Shut up. You barge in here at least once a week and kick me out. I’m taking this coffee and you’re gonna shut up about it.” She leaves the room and heads down stairs.

Sam chuckles at Cas who is left standing there speechless.

As Jess makes her way down stairs, she hears someone knocking incessantly at their front door.

She opens it and a shorter woman with dark hair stands there. “Hey. Is, uh, Winchester home?” She asks.

Jess crosses her arms across her chest in defense, “Yes. Who are you?” She snaps.

She holds up her hands in surrender, “Woah. I’m not here to steal your guy.” She laughs. “I’m an old friend. My name’s Ruby.” She holds out a hand.

“Uhh. I’m Jess. Sam is upstairs.”

Ruby bursts inside, running upstairs, calling out to Sam. “Sam!” She finally finds Sam and Cas in his room and she barges in. “Sam!” She jumps on the bed and hugs Sam.

“Ruby?! Oh my-It’s been forever!” He hugs her. “So, that blond downstairs is your wife? ‘Cause if so, then, hot.” She laughs.

“Right?” Sam adds, also laughing.

“Uh, hey!” Cas interrupts, obviously uncomfortable with this intruder. “Who are you?”

“I’m Ruby. Who are you?”

“I’m…I’m Castiel.”

Sam and Ruby immediately burst into laughter and Cas is not feeling welcome in the room anymore so he goes downstairs and finds Jess sitting in the kitchen. He plops next to her with a sigh.

“Apparently they, and a few other friends, went backpacking through Europe or something…”

“Mmm.” She responds as she sips her coffee.

“…before med school. You know, that woman all but kicked me out of the bed?”

“That’s terrible. I really feel for you.” She deadpans.

“You know, he’s never even mentioned that Ruby even existed. I mean, how good of a friend can she be?”

“Good enough to kick us both out of bed.” She whispers, “Welcome to my world.”

Cas says nothing as he sips his coffee.

An hour or so later, Cas, Sam, Jess, and Ruby are all walking into the hospital to start their day.

“You know,” Ruby begins, “this man is the reason I went to medical school in the first place.” She gestures towards Sam who smiles softly. “I figured that if a dork like Sam could handle cutting people open, then I could, too.”

“So Ruby,” Cas interrupts, “you postponed your residency to work in a morgue?”

“Yeah, you know, a lot of the fun cutting, none of the rules. But I got bored. I started craving blood that was flowing.”

“And know you’re working here! It’s awesome!” Jess and Cas can’t reciprocate Sam’s excitement, but Cas returns a half-hearted, “Yay.”

Throughout the whole day, Cas has been noticing that his interns are tiptoeing around him. They’re stammering a lot when Cas asks them what the deal is and they’re stories are inconsistent. Cas brushes it off, not thinking that it’s not a big deal. Hopefully.

 

* * *

 

 

Jo approaches Cas, “Hey have you heard of a heart guy named Dixon?”

“Dixon? Uh, no. Not a guy. I’ve heard of a Virginia Dixon, though. She’s got an incredible record. Really low mortal-“ he pauses, “Wait. Is she coming here?” He’s having a hard time hiding his excitement.

“Yeah, today.” Jo laughs. “Piggyback heart transplant. I’m on the case.” She taunts.

“What? What? W-why am I not on the case?” He panics.

Jo just shrugs and walks away.

Later on, Cas finds himself assigned to the Pit and, of course, Dean is working today. Shocker.

He struggles to tie his trauma gown behind him and Dean comes up behind him, pushing his hands out of the way, “Here. Let me…”

“Hello, Dr. Winchester.” He mumbles.

“Dr. Novak.” He smiles softly. “You’re with me, today?”

“It appears that way.”

Dean finishes tying Cas’ gown.

“Thank you.”

“You’re welcome.” He mumbles as a small smiles appears on his face.

Gabriel comes running out into the trauma bay a few seconds later, “What do we got?”

“Uh, crush injuries.” Cas answers.

“Couple minutes out.” Dean finishes.

Cas sees Gabriel struggling with his gown. He moves over to help tie it. “So, how is everything with-“

“I don’t wanna talk about it.” Gabriel interrupts. “I want guts. And mangled bones. I want a guy so badly smashed up that it’ll take all day to fix him. I want blood and guts and mangled bones. I want to rock a surgery. I don’t wanna talk about my relationships or a lack thereof.”

“Okay.” Cas backs off. Gabriel had been in a secret relationship with the previous cardio attending, the one brought in after Cas’ ex-fiancée. They had a falling out and he just packed up his things and left the hospital one day. Not saying a word to Gabriel or anyone.

The ambulance pulls in and Dean rushes to it with Cas and Gabriel right behind him.

The EMT opens the back of the ambulance, “Unidentified man with prolonged extrication time. They had to fish him out of a working garbage truck. Multiple crush injuries, open fracture, G.C.S is 3, and we couldn’t unhook him in the field.”  
“Unhook him?” Dean asks.

“His femur’s broken in half and it’s puncturing his torso. He’s impaled.”

They look over to the patient lying unconscious on the stretcher and can see that right leg is bent and folded over himself.

“Impaled on himself?” Cas gawks.

“Human pretzel. Awesome.” Gabriel smiles wickedly.

Dean, Cas, and Gabriel bring the patient into a trauma room and Sam in called in to help.

“Wow.” He breathes as he walks into the room.

“Check his popliteal pulse.” Dean commands.

“I’m getting nothing.” Cas sighs.

“That’s because his knee is over here.” Gabriel points.

“Do you think he was sleeping the dumpster and they started crushing the trash?” Cas leans down to check his breath sounds.

“That’s a bad day. Where do you need me?” Sam looks to Dean.

“Uhh..we’ll need you when we try to un-impale him.”

Ruby walks in, “I’m here. What do I do?”

“Uhh. It’s your first day so just stand over there and be quiet.” Cas points at the corner of the room and Sam shoots him a glare. Ruby scoffs and moves over to the corner.

Cas go back to check the patient’s lungs. “Breath sounds are clear and equal. Both sides. Amazing.”

“So no punctured lung.” Dean begins, “We’ll need a portable x-ray and an ultrasound.

Benny and Jess walk into the room, “Someone paged us?”

“I did.” Dean answers.

“You did?” Benny laughs. “That’s a first.”

“So is this. I’ve seen a lot of trauma-guys cut in half, amputations, eviscerations-but I have never seen anything like this. I wondered if you could help.”  
Benny stares back, not quite sure what to do but he eventually smiles, “Let’s do it, brother.”

Bobby, Ellen, and Jo are walking through the hospital and Bobby is obviously nervous.

“It’s just that this is my third cardio attending in one year, Ellen. I need this one to stick. And I just want to warn you that she’s a little off, okay? So we are wooing today, you understand?”

“I can woo with the best of them, Bobby.” She smiles and pats his shoulder. He walks away.

“So, what? Dixon’s a nutjob?” Jo asks.

“Come on, honey. I’ve had my bad days, you wanna judge me? Bobby said that we are wooing today so it’s our job to be impress her. So be impressive.”

Bobby comes back, “Here she comes! Heads up!”

Ellen and Jo straighten their posture as Dr. Dixon rounds the corner. She’s an older woman, in her early 50’s. Pale skin, dark, long hair. She has a sort of, different way of carrying herself and Ellen nor Jo can figure out why.

“Uh, Dr. Dixon! Hi! Welcome to Seattle Grace.” Ellen flashes her biggest smile. “We’re very happy to have you here.” Dr. Dixon sticks out a stiff arm to shake and Ellen grabs it. “We’re very happy to have you here today. I’m Dr. Harvelle.” She finishes.

“I-I brought my own lab coat. I’m here to perform a heart transplant today. I do hearts.” Ellen just nods her head. Kind of thrown off at how she speaks.

Dr. Dixon continues, “A procedure invented by Christiaan Barnard in 1967. I do hearts.” She finishes weakly.

Bobby and Ellen stare, not quite sure if it’s their turn to speak, but Bobby speaks up, “Uh. I’m Dr. Bobby Singer. We spoke on the phone.” She sticks out a stiff arm again and Bobby shakes it. “Uh, Jo…” he continues, “…would you get Dr. Dixon the latest labs?” She hands them over and Dr. Dixon nods. “Now, let’s go prep the patient. Right this way, please.” He leads them all to the cardio wing where the patient waits.

Gabriel examines an x-ray of his patient’s leg, “His femur’s in pieces, I mean, except for the part that’s stuck in his torso. There’s no way I’m saving that leg.”

“It looks like the impaled piece is lodged under his clavicle.” Benny adds.

“C-spine looks clear. Without a C.T. it’s hard to be sure.” Jess adds as she stares at the scan.

“Why can’t we get a C.T.?” Ruby asks.

“Because of the way that he’s impaled, it would be hard to get a clear reading.”

“You know, there is such a thing as a stupid question. Stand over there.” Cas snaps.

Ruby rolls her eyes, but steps back.

“Guys, guys. We have a very limited window here, okay? With vital like these, in a few more hours-“

“His body won’t be able to withstand surgery at all.”

“Good thing he’s unconscious.”

“Well, we can’t do anything until we dislodge the femur from his clavicle.”

The doctors begin talking over one another, trying to get their point across until Dean quiets them down. “Let’s un-impale him, then. Novak, Sam, new girl, hold his shoulders. Brace him hard.”

“I’ll hold his c-spine.” Jess moves into position behind the patient’s head.

“I got his torso.” Benny moves into position.

“I need to guide the posterior hip dislocation.” Gabriel moves in and grabs the leg that’s impaling his torso.

“They second that leg is out,” Dean begins, “Be ready to assert pressure to stop the bleeding. Got it?”

“Better than working with corpses, right?” Sam whispers to Ruby.

“On the count of three. One…two…three!”

The doctors each are pushing and pulling in their respective parts and they can hear the bones cracking as they break free.

“Okay, push directly on the clavicle while I pull.”

“The femur’s really wedged in there.”

“Okay, almost there. Almost there. Steady. Just a little bit further. Benny, I need you to, umm, rotate his knee to my right.”

But before Benny can do that, the patient that they are trying to unfold from himself, is no longer unconscious and screaming in pain, causing all of the doctors to scream but they continue working.

“Push 10 of morphine, now!” Dean commands.

“Oh, uhh…okay.” Cas hesitates, still shaken up.

They get the femur out from his torso and slowly bring the leg back down to where it’s supposed to be.

“Hold the pressure!”

“Okay, get his femur stabilized and down by his side!” Gabriel yells over the screaming patient.

They get the leg back down and eventually he stops screaming.

“Corpses don’t do that.” Ruby jokes.

The patient begins groaning from pain again and he thrashes around, trying to get up from where he’s at.

Dean presses down on him, “I need you to calm down, sir.”  
“What are you doing to me?!”

“Sir, can you tell us your name?”

“Get out of my face! Get your hands off of me! You’re hurting me!” He tries to move away from Jess, who is suturing a cut on his forehead.

“Do as he says. Hands off, everybody.” Dean says.

Slowly, one by one, each of the doctors back off from the patient.

“Thank you. What’s your name?”

The patient whimpers, “Timothy Miller.”

“Mr. Miller, w-we need to get you into surgery.” Gabriel quickly adds.

“I’m gonna be able to walk, right? I gotta be able to walk.”

“Right now, we’re just trying to keep you alive.”

 

* * *

 

 

Ellen is still walking with Dr. Dixon and she leads her to where the patient is being held.

“Our cardiac wing is extensive and well-equipped with all of-“  
“The first successful heart transplant was performed on September 7, 1896, by Dr. Ludwig Rehn, Frankfurt, Germany.”

“Okay.”

“Uh, excuse me. I don’t mean to interrupt. Uh-“ Jo comes up.

“Please inter-I mean, just, uh, please update Dr. Dixon on the patient.”

“Uhh…Dr. Bradbury is prepping your transplant patient for surgery. They scheduled a-a transplant six years ago, but the heart was too small, so they doubled up and added a donor heart to help his own heart function. They did a piggyback-“

“Heterotopic transplant. ‘Piggyback’ is the colloquial name for the procedure. Don’t do that.” She shakes her head. “Don’t do that.” She whispers.

Jo doesn’t know how to respond so she doesn’t.

“How about we take you to meet the patient?” Ellen asks.

She nods and they walk towards the room.

Back over with Dean and the rest of the doctors, they’re trying to convince him to go into surgery.

“I don’t wanna live if I can’t walk. I need to walk.”  
“We’ll do our best to save the leg.”

“I’m homeless. Walking is how I survive. It’s how I…get from one day to the next. Marion Street’s café from 2:00 to 6:00 am. And then I walk over the bridge, and I hang there until 6:30 until the traffic hits. And then I go over to Belltown and hangout downtown. And if it’s trouble, then I go back up to 4th street. I’m homeless. I-I can’t not walk! What am I gonna do?” He sobs.

“Your injuries are critical, if we don’t get you into surgery-“

“Will your surgery make me walk?”

The doctors don’t respond.

“Then I don’t want it!”

Dean nods his head, “Okay. Alright. You heard the man. The surgery’s off.”

All the doctors in the room look at each other to see if they’re going to speak up. No one does.

Dean is scrubbing out from the trauma and Jess approaches him, “So that’s it? No surgery? You’re just gonna walk away?”

“I’m respecting the patient’s wishes.” He grabs a towel and dries his hands off.

“The patient’s unstable with an open wound.”

“Which we are packing.”

Benny walks up, “This guy is circling the drain.”

“You cannot just walk away.”

“Don’t tell me how to run things in my E.R.”

“’Your’ E.R.?”

“We save lives here. We don’t just patch up patients and leave them to die.” She pauses, “If you can’t handle that, go back to the desert and leave us here to do our jobs.”

Dean doesn’t say anything. He stiffens his jaw and throws the towel down and walks away.

Gabriel, Sam, Cas, and Ruby all walk out to see what’s going on.

“Dr. Milton, please tell me that you can figure out some way to build this man some legs.”

He raises his eyebrows at Jess, “Uhh. Yeah. I think I can figure something out.”

They crowd in one of the labs trying to come up with a game plan.

“The right femur’s toast. So is the hip and half the pelvis, but if I put some pins here and maybe a plate here…” Gabriel points at the computer screen, “I mean, there are some viable bone fragments. We’re not starting from nothing. What do you think?”

“I think its wild.” Ruby says softly from the back of the room.

“She wasn’t talking to you.” Cas snaps.

“It’s her first day, could you maybe go a little easy-“ Sam whispers to Cas.  
“No. She’s an intern. She needs to learn her place. Just like we did.”

Sam sighs and lets it go.

“I think it’s a lot of hardware.” Benny adds. “What the guy needs is a whole new leg.”

“Well, maybe I can do that. I need you guys to grab every piece of titanium in this hospital.”

 

* * *

 

After hearing that Dr. Virginia Dixon is in the hospital, Cas has been eager to meet her.

He has a brief break from Timothy’s case and finds her.

“Dr. Dixon? I’m Castiel Novak. I’m a resident here, and I’ve been focused on cardio since I began my internship. I’m certainly looking forward to anything that you might-“

“Were the other ones taken off my case?”

“Oh, uh, what other ones?”

“Uh, the older one, the blond one, and the one with red hair.”

“Uhh…not that I’m aware of.”

“Then why are you talking to me?”

Cas is taken back by how blunt this woman is, so instead he just turns and walks away.

 

* * *

 

 

Dean pulls the curtain back and steps inside where Timothy is.

“Can’t you people let a guy die in peace?” He moans.

He checks his chart, “Your, uh, vitals are slipping. I’m not gonna lie to you, that’s not good.”

“I’ve been through worse.”

“Yeah, I imagine you have.” Dean walks over to stand on Timothy’s side.

“Oh, don’t get like that. Don’t look at me like I’m some tragic hero with a secret past.”

“You have a story. Man, we all have a story.”

“I took a turn in my life. And I couldn’t connect. I lost…I couldn’t connect. My life, it took a turn and…and I just couldn’t turn it back.”

Dean just stands there, softly nodding his head. Ever since he got back from the war, he’s had trouble connecting too but he’s never been able to talk about it. He moves in and checks the patient’s breath sounds and Jess walks in, “Mr. Miller.” She greets with a small smile.

“What does a guy have to do to get a little peace and quiet around here?”

“The fatigue you’re feeling is from the blood loss. The queasiness, the dizziness-it’s because you’re slowly bleeding to death.” She continues.

“Are you trying to scare him?” Dean turns to her and snaps.

“No. I’m trying to ascertain whether he’s suicidal or just defeated.”

Dean nods his head and turns back to Timothy, “Mr. Miller, you survived in the streets, so I know you’re a fighter.”

“That doesn’t make me a fighter. It makes me lucky.”

“How long you been out there? Ten years? Twenty? You’re not in jail, you’re not dead. That’s not luck. You’re smart. You gotta be smart to take care of yourself on your own.”

“I guess.”

“This…what you’re doing right now, Mr. Miller, refusing surgery, it’s not smart.”

“There’s a rehab center not too far from here.” Jess adds, “Medicare takes care of it. You could stay there. Food, bed, long as you need.” She smiles softly.

Dean turns back at Timothy, “Just let us operate. Just let us operate and we’ll figure the rest out.”

“Alright.” He whispers, “I’m in.”

Dean smiles softly and nods his head at Jess to get the O.R. ready.

Gabriel, Benny, Dean, Cas, and Sam have all scrubbed in to help with the operation.

“Just thought I’d stop in to see how everything’s going.” Bobby walks into the O.R.

“Well, I’m still several hour away,” Gabriel begins, “…but I may actually pull this off-rebuilding a man’s skeleton. From scratch.” He laughs softly.

Benny makes the comment that one of Cas’ interns can stitch better than Jess and Bobby is quite impressed. “I haven’t made my decision yet for which resident gets the solo surgery. But you keep teaching your interns like that, Novak, and you’re my one to watch.” He walks out of the O.R.

Cas just stands there. He thinks back to when he could’ve possibly had the time to teach his interns anything, and he has never had the time to, let alone teach them how to do a pulley stitch, which he could barely do himself.

The monitors hooked up to Timothy begin beeping erratically.

“He’s crashing! V-Fib!” Sam states.

“Start C.P.R.” Dean calls out, “Push 1 of Epi and charge the paddles to 360.”

Cas begins doing compressions and Sam gets the defibrillator pads ready. “Clear!” He shocks him, but nothing changes. “Charge them again! Clear!” Nothing. “Shit!” He flatlines.

Dean calls it, “Time of death: 3:46 pm.” He rips his surgical mask off and throws it on the ground.

 

* * *

 

 

“Uh…excellent job today, Dr. Dixon.” Ellen approaches her as she is about to get on an elevator. The doors open and they step in.

“I only have one real area of interest-the human heart. I love it. I like its regularity. I know everything there is to know about it. I like its predictability. It has rules. Every chamber has a function. Every function has a movement.” She inhales, “I like the color. It’s comforting.”

Ellen nods her head slowly, trying to understand.

“Are you familiar with Asperger’s Sydrome, Dr. Harvelle?”

“Uh, of course. A significant impairment during social situations...” she pauses and realizes.

“I’m not good at cues like sarcasm or condescension, but I do know when I’m being manipulated, and I know when I’m being made fun of.”

The elevator doors open and Dr. Dixon steps off, “I don’t think I like this hospital very much.” She turns around and faces Ellen, still standing, shocked, in the elevator, “I don’t think I like this hospital at all.” She turns and leaves.

 

* * *

 

 

Cas, fed up with his interns tiptoeing around him and their inconsistent stories, finds one and approaches her. He yanks up her sleeve and it reveals rows and rows of band-aids covering up sutures. Sutures that they put there themselves. He yanks at another intern’s arm and sees the same thing.

“I did not teach you the parallel pulley stitch. I can barely do that stitch myself. Whatever you guys are doing, shut it down. Do not practice on yourselves. That is insane. Shut it down.” He orders and walks out of the room.

 

* * *

 

 

Cas meets up with Benny, Sam, and Jess after work for drinks. He hears the bells ringing from someone coming in the bar and looks. He sees Dean and they make eye contact, but Dean turns and walks right out of the bar.

Cas chases him down the alley, “Hey.”

Dean startles and turns around quickly, taking a step back from Cas.

“I’m-I’m sorry we lost him. The patient. I’m-I’m sorry.” He looks at Dean but is confused as to why he was startled so easily. “I’m sorry-“ he takes a small step towards Dean.

“I don’t need you to be sorry.” He snaps.

“Okay.” He takes a step back.

“I don’t need you to be sorry.” He snaps again, a little more aggressive. Taking a step towards Cas.

“Okay.” Another step back.

“I don’t need-“ He takes more steps towards Cas and backs him into a wall.

“Al-alright. Alright. Alri-“

“I don’t need you.” He has Cas pushed all the way against the wall and he’s inches from him.

“Okay.” Cas whispers.

Dean looks down at Cas’ lips and surges forward with force and kisses him. Hard. He keeps pushing Cas against the wall to deepen the kiss. Dean slides his tongue in with Cas’ and he shies away, but Dean presses harder into Cas, rutting his hips against Cas’. He eventually lets himself go and he kisses Dean back with the same passion. He runs a hand through Dean’s hair and grabs a handful and tugs softly. Dean pulls back from the kiss, panting and looking into Cas’ eyes.

All he sees is Cas looking back at him with a worried and confused expression.

Dean looks at him with sorrow as he caresses Cas’ cheek with his hand.

Cas pushes Dean back with a stiff arm and walks away down the alley without a word.


	5. In The Midnight Hour

Early the next morning, Cas walks to the hospital. He passes Dean who is standing in the trauma bay awaiting the arrival of an ambulance that is a few minutes out.

Dean sees Cas and turns to him, “Dr. Novak?” He’s hopeful that Cas could stand to talk to him right now.

“Dr. Winchester.” He didn’t expect to see him there.

Dean stammers as Cas turns to walk into the hospital, “Are-are you here f-for me?”

“What?”

“I-I meant my-my trauma.” He rubs the back of his head and laughs lightly.

“I’m here for a possible Appy. The ambulance is on its way in.”

Dean nods his head slightly, trying to come up with something to say.

Cas turns to go into the hospital.

“Hey, uh…” he pauses.

Cas turns back to him, “Did you want to say something?”

He laughs softly, “H-How did you beat the ambulance?” He smiles.

“I live across the street.” He points and turns and walks away.

 

* * *

 

 

Cas, Sam, Kevin, and Jo have all met up in the hallway, and now they’re arguing about who gets this new patient.

Ellen walks up to them, “What are you all doing here? It’s 3:00 in the morning!”

They all begin talking over each other.

Cas speaks first, “Oh, uh, he’s mine! I met the ambulance.”

“And he’s sharing him with me.” Sam smiles.

“I’m the doctor on-call tonight, so he’s mine!”  
“Like that even matters, Kevin!” Jo shoves him out of the way.

“I got here first! And the Chief said that I’m the resident to watch.” Cas shrugs as all the other doctors around him scoff.

“Oh, I get it.” Ellen smiles. “It’s solo surgery time, and you all have heard that the past two years, the Chief has assigned an appendectomy. So you little ‘mini-surgeons’ dragged your asses out of bed to pick up some final tips from the master. It’s kinda cute.” she shrugs. “Alright, I can use two of you.”

“But I’m on call!” Kevin shouts.

“I just filled Sam in on the case.”

“Jason Kron, 47, tenderness over McBurney’s point.” Sam finishes with a smirk.

“Hmm. Jo? What do you know about Mr. Kron?”

She doesn’t say anything.

“That’s what I thought.” She laughs. “Cas and Sam, you’re on the case.”

A smile plasters over their faces and they turn to go prep their patient for surgery.

 

* * *

 

 

Meanwhile, Cas and Sam’s interns have gone rogue.

All of them have been secretly practicing on each other and Ruby had volunteered to let them remove her appendix for the practice.

While in surgery, things start going bad and they do not know what to do.

One of Cas’ interns, Adam, approaches him and Sam with tears in his eyes, “We need you to come help up us.”

They rush in and see that Ruby is lying on an operating table with another intern standing above her, suctioning the excess blood out of her. “I-I think she’s dying.” He stammers.

Cas and Sam quickly scrub in and help.

“Her B.P. is dangerously low.”

“We need to push two liters of L.R.”

“Should we call a code?” Adam asks.

“There is no code team in Outpatient Surgery in the middle of the night because normally, this procedure would be done by a surgeon in a regular O.R.” Cas snaps.

“Adam, page the Chief and go get Ellen, and tell her there’s an emergency. You’re not to say anything else.” Sam tells him.

He quickly runs out of the O.R and finds Ellen.

“Dr. Harvelle…” she begins, shaking, “…there’s an emergency in Outpatient Surgery.”

“What kind of emergency?” She asks.

“There’s a…it’s an emergency. Please…come….” He turns and runs back towards the O.R.

Ellen raises an eyebrow at her, but follows.

She enters the O.R. “Okay, what the hell is going on?”

“We were trying to take out her appendix.” One of the interns says.

“Well, whose foolish idea was that?”

“Mine.” Once of Cas’ interns admits.

“Shit…” Ellen breathes and approaches the table, “Where are we?”

“We just found the artery in the mesoappendix. Apparently, the stitches the interns did came off.” Sam says.

“Hand me another 3-0 silk.” Cas calls. “Dammit. I need some more suction. How’s her pressure holding up?”

“74 systolic.”

“She is really bleeding. I can’t see anything.”

“The stump isn’t closed right. She needs a partial cecectomy.”

“I can’t get to the appendiceal artery.”

“Come on. Yes, you can, Cas. You almost had it.”

Sam applies more suction, “Is your visualization better?”

“No, I still-I can’t see anything.”

“Look, look. Don’t panic, son.” Ellen soothes. “Here. Put that down. Feel down for the mesoappendix.”

Cas moves his hands, “Okay.”

“Find the pulsations. Now follow it to the end.”

“It feels…okay, I think I got it.”

“Good. Here, place your clamp.”

Cas grabs the clamp from her and places it.

“Okay. Good. Sam? You tie it off while Cas holds the clamp in place.”

“Stick tie or ligature suture?”

She shakes her head, “Whatever works. You’ll have to do what feels right to you.”

“Ligature suture.” The nurse hands him the suture and he does it.

After the surgery, all of Sam and Cas’ interns are sitting on the floor in the hallway outside of the O.R.

“Are we gonna go to jail?” One of them asks.

“You’re not gonna go to jail because you didn’t have the balls to stay in the room. The rest of us, are gonna go to jail.”

Sam and Cas approach Bobby and he pulls them into a conference room for privacy.

“I was sleeping. And sleep isn’t easy for me to come by. But when I was finally sleeping, I get a call-“

“I can’t believe it. I still can’t believe it.” Sam interrupts.

“Don’t beat yourself up too much about it, boy. I’ve seen a lot of maturity in the two of you through this whole mess. You handled the crisis, you handled the surgery, you saved that girl’s life. And you called for help right away. There was a time not so long ago that you would’ve reached a different conclusion. You could’ve stuck to the code and saved your own, tried to hide the whole mess. I’m glad to see that you know when to call for help now.”

Adam barges in, “Chief, you don’t-I can’t let you two get in trouble for this.”

Cas tries to stop him but he doesn’t listen, “No, it’s not right. People tried to stop me. Dr. Novak told me yesterday to shut it down, but I didn’t listen.”

Bobby turns to Cas, “You knew about this yesterday?”

“Sir, I-“

“Did you know?” He asks Sam.

“No.”

“Alright. All of you, get out. I need to figure some things out.”

Cas storms out of the room and Sam follows.

He finally catches up and pulls him by the arm, “You knew that they were gonna cut her open?”

“No!” He rips his arm from Sam’s grip.

“Your intern just said that you knew!”

“Sutures! I knew they were doing sutures on themselves. And I didn’t think that I had to say anything because I had shut it down. I had handled it.”

“Apparently you didn’t because it almost caused Adam to lose his job, and not to mention, Ruby just almost died!”

“Okay, you know what? Ruby did that to herself. And let’s stop pretending that you care about Adam.”  
“I care about my job. And I care about doing the right thing!” He snaps.

“Who are you to lecture me about doing the right thing? Are you kidding me? You’re not an attending, Sam! You may be married to one, but you aren’t one yet.”

“Is that what this is about? Jess?”

“No! It’s about you and me, and the fact that you didn’t have my back in that room.”

“What would you have wanted me to say?”

“I don’t know. Anything! You should’ve said anything! You’re close with Bobby. You have his ear, but you didn’t say anything to defend me. Because this isn’t just on me. I mean, you just stood there, and you watched him take me out of the running for solo surgery. You let me take all the blame, but the fact is that we both had interns in that room. We both failed to supervise them. And if your friend had died in there, if you and I hadn’t saved her life, that would’ve been on both of us, too. You should’ve said that.” He turns and yanks the door open and leaves.

Later on that morning, Sam and Cas take their interns on their morning rounds.

They walk into Ruby’s room and stand around her bed.

“Dr. Milligan. Present.” Cas orders.

“Ruby is three hours status post-appendectomy complicated by severe hemorrhaging.”

“Sam?” She looks at him, confused. “What is this?”

He ignores her, “What else, Adam?”

“Vitals stable, triple antibiotic coverage. She should fully recover within two weeks.”

“And?” Cas asks.

He looks at Ruby, “And…we, your surgeons, made mistakes that compromised your care, mistakes that reflect poorly on this hospital and that won’t happen again.”

“Effective immediately, every intern here is on probation. So much as sneeze, and you’re done.” Sam says.

“None of you will see the inside of an O.R. until further notice.” Cas continues.

 

* * *

 

 

A few hours later, while Sam is doing his rounds, he comes in and checks on Ruby.

“Okay, fine. The surgery was a bad idea.” Ruby says.

“No, it was a terrible idea. And speaking as your boss, it was an irresponsible and reckless idea that makes me seriously question if you have what it takes to be a good doctor.”

“Sam-“

“And as your friend,” he sighs, “what the hell is going on with you?” He sits on the bed next to her.

She sniffles as a tear runs down her cheek, “I don’t know.”

“It’s okay. We’ll figure it out.” He kisses her forehead and walks out of the room.

 

* * *

 

 

Later on that day, Cas is walking back to his apartment and sees Dean sitting on his doorstep.

He looks up at Cas and scoffs, “I don’t know why I came here.” He looks down at his fidgeting hands.

Cas just looks at Dean, confused, “Do you want to come in?”

“No. No. I-I don’t think that’d be appropriate.”

“Well, do you want to go someplace else?”

Dean sighs, “No.” He shakes his head.

Cas nods and decides to sit next to Dean on the steps with their knees barely brushing against the other’s.

Cas looks at the ground, not saying a word and Dean turns to look at him. “I think you’re beautiful, Cas.”

He turns and smiles softly at him, “Thank you.”


	6. All By Myself

Bobby gathers all of the residents into the hallway, “I’m happy to announce that the first solo surgery will take place tonight – a below-the-knee amputation, bone cancer. For the patient in 2212.”

“No appy?” Sam whispers to Charlie.

“Saw action. Sweet.” Jo grins.

Bobby continues, “Choosing who gets the first solo surgery isn’t just about who has the best surgical skills or who’s logged the most hours in the O.R., it’s about the highest form of trust – the trust to put a patient’s life into one of our resident’s hands. And for the first time that I can recall, every single attending picked the same person. Dr. Novak.”

Cas is standing behind Bobby, looking very angry.

“However, Dr. Novak is out of the running. He is going to pick the winner instead. Dr. Novak will post his decision on the O.R. Board at 4:00 pm. Also, since your interns are still banned from the O.R., the winner will be allowed to pick a fellow resident to scrub in with them. Good luck.”

The residents all turn and walk away as Cas stays behind with Bobby.

“This is torture for me.”

“Oh, I’m not even done, boy.” He grins.

“Sir?”

“Dr. Dixon’s back. You will be spending the day with her. You will impress her. And you will make sure this hospital impresses her. By the end of the day, I want that woman to be my next Head of Cardio. If she’s not, I’ll know who to blame.” He turns and walks away.

Throughout the day, Cas has a bunch of residents are pestering Cas to persuade him to pick them to do the surgery.

Finally, Charlie speaks up, “You’re all just wasting your time, guys. We all know who he’s gonna pick.”

“He’s not gonna pick me because I’m his best friend, he’s gonna pick me because I’m the best.” Sam smiles.

“Okay, stop! Are you guys kidding me?”

Everyone just stares back at him.

“Fine. I’ll think about it. Just…go and do surgical things.”

 

* * *

 

 

The stress of picking one of his colleagues to perform the surgery that he, technically, won, plus the stress of having to deal with Dr. Dixon again is putting Cas on edge.

He finds himself yelling at one of the nurses, “Dr. Virginia Dixon! Where is she? It says that she arrived over half an hour ago!”

Dean approaches him from behind, “Nervous?”

Cas turns around, “What? What are you doing here? This is the cardio wing.”

“I know. I was just looking around and getting to know other parts of the hospital.”

“What else is there? The O.R. the E.R. and the place with the food.”

He chuckles, “Someone’s got a lot to learn.” And walks away, smiling at Cas.

 

* * *

 

 

After searching around the hospital for almost an hour, Cas finally finds Dr. Dixon.

“Dr. Dixon, there you are.” He greets with his best fake-smile. “I’m Dr. Novak.” He reaches a hand out to shake hers, and she flinches back from it, not saying anything.

“Great. Well, I’ve been assigned to work with you today. I was in the cardio lab looking for you. I’m so sorry it took me so long.”

"There’s a blank spot on this board.” She points to the O.R. Board that they’re standing in front of, “There’s a surgery but no surgeon. I would like to do a surgery. But it’s an amputation. I haven’t done an amputation since my residency.”

Cas sighs, “Well, umm,” he runs a hand through his hair, “that’s…it’s really hard to…umm, that…”

“Is your stuttering pathological and persistent or is it occasional and stress related?”

Cas gives her a confused look, “I don’t…stutter.”

“I had persistent pathological stuttering as a child, but it can be treating with rigorous speech therapy.”  
He sighs, “Yes, ma’am. Thank you.”

She turns back to the board and points at it, “Why is this spot on the board blank?”

“I need to select one of my fellow residents for that slot.” He stuffs his hands into his lab coat pocket and looks down at the ground. “It’s the first solo surgery of my class.”

“The Chief asked you to choose from your peers?”

“Yes, ma’am.”

“That is rather unfortunate.”

 

* * *

 

 

Jo and Jess are giving one of their patient’s a C.T. scan, “Hmm. Looks like the hemopericardium. Let cardio know.” Jess tell her.

Sam walks in, “Hey, I’ve got a patient out here who needs a C.T.”

“Hey, uh-“ Jess begins.

“Oh, I’m not mad at you for not voting for me. It would’ve looked like you were playing favorites, even though I am your favorite.” He smiles at her.

“Good. You deserve it. Cas knows that, even if you two are fighting.”

Jo chuckles, “You and Novak are fighting?”

“We’re not fighting. Fought – past tense.”

“Yeah, okay. Well you better go make sure that he’s thinking the same thing.”

 

* * *

 

 

Sam finds Cas sitting in a stair case, looking through a patient’s chart.

“Hey.”

Cas looks up at him, but looks right back down at his papers.

“So, you know I deserve this. You know I’m the most qualified. But, I don’t want it to be a big, awkward thing. I don’t. So, you know, you do what you have to do.”

“Okay.”

“Okay. I’ll see you later. ”

 

* * *

 

 

“Be objective, Dr. Novak.” Jess tells him while they’re performing a surgery. “Consider accomplishment, achievements, look for the standouts. Right now, let’s see what kind of standout Dr. Harvelle proves herself to be when I ask her to sew the graft.”

“Really?” She asks.

“Absolutely. Dr. Novak, watch Jo to see if her skills are up to par for the solo.”

“A system. Devise a system.” Dr. Dixon interrupts. “Rank everyone accordingly. That’s all.”

 

* * *

 

 

Jo approaches Cas, “Dude. You were robbed. You got screwed by politics. The Chief, he needed a scapegoat. It’s so unfair.” She sighs and begins laughing, “I’m sorry. I-I can’t do this. I can kiss ass when I have to, but not yours. Uh…” she clears her throat, “below-the-knee amputation: make a transverse incision at the mid-shaft of the tibia, elevate the periosteum and cut the tibia and fibula with a bone saw, ligate the vascular bundles and release the tourniquet. I’ve done four of them – one on a cadaver and three on surgical mannequins.” She exhales deeply and walks away, leaving Cas standing there confused and not quite knowing what to do.

That’s when Dean approaches.

“You know who you're gonna pick?"

"Well I'm ranking them according to a system. You know, surgical skills, hours in the O.R., published papers, academic accomplishments-"

He moves in to sit across from Cas. "You know them. You know their capabilities. Go with your gut."

"My gut? I'm not putting a patient's life in the hands of a novice surgeon based on my gut."

He chuckles, "Well it worked for me."

He scoffs, "Your gut?"

"It's what told me to choose you." He stands up and walks away.

 

* * *

 

 

It’s 4:00pm and Cas has to make his decision already.

He approaches the O.R. Board and everyone is gathered around, waiting to see who he chooses.

In the slot where it says ‘Resident:’ he writes ‘Harvelle’.

“Interesting choice, Novak.” Bobby tells him.

“She made the best case.” Cas walks passed him, trying to keep an unemotional expression on his face.

Bobby scoffs and walks over to where Dr. Dixon is standing, “Dr. Dixon. How has your day been? You feel like you may have a home here at Lawrence Grace?”

“Dr. Novak – you tortured him today. Making him choose among his peers, some kind of emotional torture, was that your intention?”

“Uh, yes.” He sighs.

A small smiles appears across her face, “Have your board make me a better offer.” She walks away.

 

* * *

 

 

The observation deck for O.R. 2 is packed with everyone anxiously waiting to see Jo perform her solo.

Sam walks in and sits next to Cas, “Look, dude. We’re fighting, and I don’t want to be. Let’s just put this passed us. What happened with the Chief and the interns, it doesn’t matter. I know that’s why you didn’t choose me, and I know that’s why you made it personal. So, let’s just move on.”

Cas narrows his eyes at Sam, “You made it personal. This, right here, is you making it personal. You told me to do what I had to do, so I chose Jo. She was the most prepared. That’s why I didn’t choose you – not because we’re fighting, but because, unlike you, I can separate my personal life from my job. You made it personal.” Cas sighs and stands up, looking at everyone in the room, “You never said anything! Those were your interns too! But I won this. They picked me. If I don’t deserve this solo surgery, none of us do.” He storms out of the room.

Seeing that Cas is upset about this, Dean follows him out of the room. He catches up to him in the hallway and Cas is seconds away from crying because he’s so frustrated.

Dean approaches him from behind, “Not here.” He walks passed him and opens the door to the stairwell, motioning for Cas to follow him.

Dean leads him down into the basement of the hospital, navigating through dark and narrow hallways and leading them to a door.

“Where are we going?”

“Don’t worry, Cas. You’ll like it.” He smiles as he opens the door. “Come on.”

Cas walks inside and Dean closes the door behind them.

Dean directs Cas to stand above a large air vent on the floor.

“Uhh. What-“ Cas protests.

“Wait. Just wait.”

A few seconds later, warm air rushes up through the vent, blowing through Cas and it takes him completely by surprise. He breaks out in laughter, loving it.

“It’s good, right?” Dean smiles at him.

Cas continues to laugh as the air continues to blow and Dean thinks that it is the most wonderful sound he’s ever heard.

“It’s the vent. It clears your head. You feel better, right?”

Cas laughs, “Yeah.”

“It’s out of time, out of space. Anything can happen on the vent.” He steps closer to Cas, “Anything.”

“Like what?” Cas leans closer to him.

“Just wait.” Dean whispers.

Air whooshes up through the vent again and Cas begins laughing again. Dean stares at Cas, completely awestruck by him. They lock eyes and Dean leans in and Cas closes the distance between them.

Dean leans into the kiss a little bit more and runs a hand through Cas’ hair, pulling him closer.

**Notes for the Chapter:**

> Okay, I know that there A LOT of subplots happening here, I'm sorry! But they all contribute to Dean and Cas' story in the end. Be patient and it'll all come together. :)


	7. Wish You Were Here

**Notes for the Chapter:**

> Dean has a minor PTSD episode during this chapter. Just an FYI.

 

Cas comes into work today, excited to work and even more excited to see Dean.

Dean, however, is not all that excited.

Cas finds him and approaches him in the trauma bay, “What do we got?” He asks with a smile.

Dean ignores him and walks away.

Cas is left standing there, not quite sure what to think, but he moves on to help out on an incoming trauma.

 

* * *

 

Cas and Sam have been walking on eggshells around each other all day.

They, with the help of Dean and Jess, have been assigned a case together and they’ve been acting very distant from each other.

Dean notices. “I thought they were friends? Sammy went on and on, talking about Cas, when I first got here.”

“They _were_ friends.” Jess sighs.

“And now?”

“You and I are in for a very, very long day.”

 

* * *

 

Later on that morning, as he’s hunched over a desk filling out one of his patient’s charts, Dean approaches him and sets down a cup of coffee for Cas.

“What’s that for?” Cas asks as he points to the coffee cup.

“It seems like you’re short of a friend today, so I thought I’d fill in.” He smiles.

“Colleagues aren’t friends. They’re competitors.” Cas mumbles.

“Oh, so does that mean that you’re not gonna drink this coffee?”

“No, I’ll-I’ll drink the coffee.” He smiles softly. “Thank you.” He takes it from Dean’s hand and Dean smiles as he takes a sip.

 

* * *

 

At lunch, Cas and Sam and a few other residents are sitting at a table together.

“So, are you guys still mad at each other?”

“I’m on Sam’s side.”

“You can’t just pick sides, Kevin!”

As they all continue to bicker, Cas and Sam sit in awkward silence.

Across the cafeteria, Cas sees Dean leaving.

He gets up and follows him out.

“Hey. I’m having a really hard time trying to not shove a scalpel down someone’s throat today because-“

“Dr. Novak, I’m working.” He gestures down to the charts in his hands and keeps on walking, leaving Cas standing there, more annoyed than he was before.

 

* * *

 

At the end of a rough day, Cas is looking forward to going home and sleeping.

Whatever game Dean is playing is emotionally exhausting for him and the petty fight he and Sam are in, is more irritating than not.

As he’s waiting for the elevator, Dean approaches him from behind.

“You okay, Cas? You wanna get a drink or something?”

Cas turns around to face Dean with a surprised expression on his face, “Oh. Oh, so now we’re on again because the mood suits you? Because I’m the sad little boy with no friend, and I tripped your savior complex into action?”

“I-I don’t-“

“Usually, I can deal with the hot and cold thing, but not today.” The elevator doors open and Cas steps inside. “Just leave me alone, Dean.”

The elevator closes and Dean shoves his hands in his pockets and walks away with his head hanging low.

 

* * *

 

The next day, Cas and Charlie are standing at a nurse’s station, waiting to get some charts and Dean approaches them.

“Dr. Novak, would you mind checking on some of my post-ops? E.R. is swamped with traumas. Also, would you like to go out on a date with me?”

A squeak of excitement escapes Charlie, but Cas is took shocked to look at her. He stares back at Dean who is smiling hopefully at him.

“I’m sorry?”

“Umm. A date. You said not to play hot and cold with you, so umm…I’ll pick you up around 8:00?”

Cas still can’t bring himself to say anything.

“Oh, and make sure Mr. Kenner in 2212 gets that enema. He’s been holding onto it for days.” He smiles and walks away.

“Uhh. Okay.” He responds weakly.

After a minute or so of silence between him and Charlie, she finally bursts with excitement.

“Cas! Ah! I’m so excited for your date! I think you and Dr. Army make a cute couple.”

“Okay.”

“What are you gonna do? What are you gonna wear? What are you gonna talk about? These are important things to know, Cas.”

“Why do you care?”

“You only get to do a first date once. It should be…fun and sexy and…oh, ask really good questions. Ask him why he first decided he wanted to save lives. Oh, ask him what his best surgery ever was.”

“I know how to go on a date, Charlie.”

 

* * *

 

About an hour later, Cas runs into Dean in the hallway.

“Dr. Winchester. I check on all of your post ops for you.” He hands Dean the charts.

“Thank you.”

They exchange shy smiles and Cas nervously asks, “So what was your best surgery?”

“What?” He’s a little thrown by the question.

“Nothing. It was stupid.” Before Dean can protest, he hurries away.

 

* * *

 

One of the patients that Dean has used to be a nurse for the Navy.

Jess introduces her to Dean, “This is Major Dean Winchester.”

“Major? Where were you stationed?”

“Umm. In the thick of it, in Iraq.” He responds uneasily.

“Welcome home,” she smiles, “you must have stories.”

“Not any worth telling, ma’am.”

“I see. Umm. How have you been sleeping?”

“I’m sorry?” He’s a little thrown off by the question.

“When I can’t sleep, I use Valerian root. I know you doctors don’t think much of herbs, but I find it helps. So, have you been sleeping? Since you came back?”

“Uh, I’m fine. I…sleep just fine. Have a good night, ma’am.” He forces a smile and walks out.

 

* * *

 

Later that night, Cas is nervously pacing back and forth in his apartment, waiting for Dean.

Finally, there’s a knock on the door and Cas rushes over to it and yanks it open, “You’re late. You’re really, really late.”

“I didn’t want you to think I stood you up.” He stumbles inside and hands Cas a single rose.

He closes the door after Dean stumbles in, “Are you drunk?”

He sighs, “I haven’t been on a date in 5 years, since before I entered the military, and I-“

Cas scoffs at him.

“I just wanted to take the edge off.”

He scoffs again, a little more angry this time, “You’re drunk? You’re late and you’re drunk?” He steps towards Dean.

“I will make this up to you, Cas. I promise. This is not what you deserve. I know this is not what you deserve, and I will make this up to you. I-I promise, Cas.”

“Okay, before you say anything else, you need to shower. You smell like a distillery.” He turns away and goes to open the front door for Dean.

Dean doesn’t get the hint that Cas is asking him to leave, so instead he searches out for Cas’ shower.

“No. Not here!” But Dean wasn’t listening.

 

* * *

 

About 20 or so minutes later, Cas finds himself sitting in silence in his living room.

“Novak! Novak!”

He jumps up from the couch and rushes into the bathroom.

He finds Dean standing in the shower with the water running on him. His clothes are still on and he looks panicked.

“I thought of it. I thought of my best surgery ever.”

“You’re wearing shoes in my shower, Dean!”

“My first blast injury in the field.”

Cas gives up, “Uh-huh.” He puts the lid down on the toilet and sits on it, listening.

"The body was mangled-homemade explosive device, copper wires embedded 5 inches deep in the abdomen, arms and legs hanging on by threads of skin. I'd never seem anything like it, not in textbook, not in residency. Incredible. A body full of holes-a trauma surgeon's dream. I put tourniquets where I could, started typing off the arteries with my bare hands. But the bleeding was everywhere-stomach, chest. The best pressure I could think of was my own body. So I-I laid there for 2 hours on top of him, just not moving, trying to keep that dam from bursting with my hands, my knees, my elbows. Body full of holes, and he never bled out. I wouldn't let him. He made it to the hospital. He made it home. A month later, he...he sent me a letter thanking me for saving his life, and then he shot himself."

He pauses. Still standing under the water running from the shower head. “That was my best. And my worst.”

Cas has no words for Dean. He couldn’t possibly understand what he has gone through.

He takes off his shoes and opens the shower door and steps inside, fully clothed as well.

He puts his hands on Dean’s face and looks into his eyes. He softly caresses his cheek and Dean leans into the touch. He moves his hands down to remove the tie that Dean is still wearing. He runs a loving hand through Dean’s hair, “I’m sorry.” Is all he can bring himself to say.

Cas guides him out of the shower and hands him a towel to dry off. He hands him and extra pair of gym shorts and t-shirt and gives it to Dean to change into. He gives him his privacy and walks out of the bathroom.

Dean emerges a few moments later, looking very tired and broken.

Cas guides him to his bed and lays him down. He pulls the covers over Dean and turns out the light as he walks out of the room.

The next thing Dean knows, he’s waking up in an unfamiliar place and he panics. He quickly settles when Cas walks in carrying a mug of coffee.

“Cas, I’m-“

“Stop. Drink this. You’ll feel better.” He hands him the mug of coffee.

“Thank you.”

“I washed your clothes for you and I hung them up. We have to be at the hospital in 30 minutes. I made breakfast, if you’re interested.”

“Yeah, uhh, great. Thanks, Cas.” He smiles.

They sit in silence at the kitchen table as Dean eats his eggs and bacon and Cas reads the newspaper. It’s oddly comfortable for the both of them, but they don’t comment on it.

 

* * *

 

Later, at the hospital, Dean finds Cas going through the supply closet. He walks in and closes the door behind him. 

"Cas, I wanted to apologize for last night. It was not my intention to arrive in that state."

"You don't have to say anything."

"As a rule, if I'm showering with another man, I do it without my clothes, and if I get in his bed naked, I don't pass out, and if I-"

"It's okay."

Dean takes a step towards him. "It's not."

"It's not. It's not...but, uh, you know, you don't have to talk about it." He walks by Dean and exits the closet.

"But I want to say this," He hurries up to Cas and steps in front of him.

“I planned a whole evening for us…last night. It was a clear night so I was gonna take you up to the look out cliff over in Westpoint and we were gonna wach the stars together.”

He pauses to look at Cas, who is looking back at him.

“I’d like another chance, Cas. I want you to give me another chance.”

“You have some problems. You have some big problems.”

“Yeah. Yeah, I do,” he pauses and Cas looks back down at his chart, “Will you go out with me anyway?”

Cas looks up at Dean and after a few moments of silence, “Yes.”


	8. Beat Your Heart Out

**Notes for the Chapter:**

> Dean has another PTSD episode towards the end of the chapter.

“Cas! Hey!” Jess whispers as they pass each other in the hallway. She pulls him into an on-call room for privacy.

“Look!” She holds up a pregnancy test, and it’s positive. She can barely contain her excitement as she beams with pride.

“Oh my gosh, Jess! Congratulations!”

“Shh! Not so loud!”

“Sorry.” He smiles really big and hugs her. “But why are we being so secretive about this?”

“Because I haven’t told Sam yet and I need your opinion on how I should tell him.”

“Well…it’s not really my place to-“

“Alright, look. I know you two are still fighting, but isn’t it about time that you two wrap that up? I’m asking you because when I tell him, he’s gonna need someone to freak out to. He misses you…a lot. You must miss him, too, right? You guys have been through too much together to be fighting over something this petty.”

He looks down at the floor and nods his head. He does miss Sam. A lot.

“Look, I don’t know what’s going on in your life right now, but you _must_ have something that you need to freak out to him about, too.”

He thinks of Dean. Yeah, he wishes that he could talk to Sam about him. Sam knows him better than anyone here, and talking with him might be able to answer some questions he’s not ready to ask Dean.

“Okay.”

“Okay?”

“I’ll fix things with Sam.”

She squeals with excitement and hugs him.

 

* * *

 

A couple days later, Cas is exhausted during his 20-hour shift and decides to take a nap in an on-call room. 

He walks inside and flips on the light switch. 

Dean gasps and sits up really quickly, startled. 

"Oh. Oh my gosh. I'm sorry."

"No, I'm sorry."

"I, uh, no, I, uh didn't even look. I'm sorry." He opens the door to leave.

Dean stands up from the bed and puts his scrub top on. "No. No."

"What-what are you-"

"No. I'll leave. Sleep. You've been here all night."

"Uhh. How do you know that I've been here all night?"

Dean scoffs and looks at the ground. "I, uhh. I just knew it." His pager goes off and he goes to leave the room. He pauses and leans into Cas' ear, "You should let your hair be messy like that more. Makes you look hot. You're always hot, but...you know." He smiles and leaves the room. 

A small smile appears on Cas' face as he sits down on the bed. He quickly ruffles his hair and lays down.

 

* * *

 

After this, their relationship is mostly centered on stolen glances and soft touches of hands.

They’re walking down the main hallway together, not saying a word and both softly smiling. As Dean turns a corner to head down to the trauma bay, he brushes his hand against the back of Cas’ and he watches Dean walk away with a shy smile on his face.

When coming back to reality, Cas nearly bumps into Sam.

“Oh, I’m sorry.” Cas softly mumbles and he quickly turns to leave.

“Cas! Wait!” Sam calls out as he grabs his arm to pull him back. “I’m sorry, okay? I can’t stand not being able to talk to you about the crap that goes on in my day. I miss my best friend.”

Cas goes through a vast number of emotions in the 5 seconds it takes for him to respond. “Umm…yeah. I miss you, too, Sam.” He smiles softly and pats Sam’s shoulder.

Sam brings him in for a hug and a Charlie and Kevin are there to witness it.

“Yes! You owe me twenty bucks, Tran! They made up!”

“Sheesh, whatever. I’m just glad that they’re not gonna be walking around all emotionally-constipated anymore.” He slaps a twenty dollar-bill in Charlie’s hand.

“Don’t hate, little man.” She smiles at him. “Sam! Cas! Let’s go get some lunch! I’m buying!” She waves the money in her hand at them and they both laugh.

In the cafeteria, Dean approaches Cas, who is sitting with Sam, Charlie, and Kevin.

Cas fumbles with the fork in his hand when he sees Dean. “Hi! Umm.” _Woah, calm down, Cas._ “Hello, Dean.”

“Heya, Cas.” He smiles.

“Are you on call, tonight?”

“Looks like it. You?”

“Mhm.” He smiles and runs a hand through his hair to mess it up a little and it makes Dean laugh.

“Awesome.” He smiles once more before walking away.

When Cas is done watching Dean walk away, he notices that all eyes at the table are on him.

“What the hell was that?” Kevin asks.

“Oh, don’t you know? Cas and Dr. Army are dating.” Charlie giggles.

“Charlie-“ Cas glares at her.

All eyes are on Sam, now.

“Did you know?” Kevin asks.

“I had no idea.” He picks at his salad, trying to not feel too hurt by this.

“To be fair, Sam, you know nothing about it because a lot has happened since our fight.”

“Yeah, true. But from now on, you’ve gotta tell me everything, dude. Well…not _everything_ …but you know what I mean.”

Cas laughs, “Yeah. I think so.”

 

* * *

 

After lunch, Cas is heading back towards the cardio wing to check on some of his patients.

He and Dean make eye contact across the hall and they both smile. As they begin walking towards each other, Dean looks over Cas’ shoulder and recognizes who he sees. Cas turns to look and he notices a woman with dark skin and very curly, dark hair, walking off of the elevator. When he turns back to look at Dean, he notices that Dean’s eyes have widened intensely and he panics. He runs off and leaves Cas standing there.

Cas follows him into the on-call room that he’s shut himself in. Dean is breathing very heavily and he’s muttering something to himself.

“What’s going on, Dean?” He asks calmly.

“Sorry, Cas.” He mutters, still pacing back and forth.

“What happened?” He takes a step towards him.

“I’m sorry. I can’t. Just-just leave me alone.”

“Dean, you’re shaking.”

“I…saw someone-someone I knew. I can’t do this. Not right now. I can’t just…”

“Okay.”

“Please, go away.”

“Okay, it’s-it’s alright. Here.” He takes a few steps towards Dean who is still pacing back and forth and breathing heavily. “It’s okay.” He reaches out and places his hands on Dean’s shoulders.

He yanks himself from Cas’ grip. “No. No. I don’t want this!”

Cas steps back. “Okay.”

As Dean turns away to continue pacing, Cas wraps his arms tightly around his torso.

Dean yells, “I don’t want this! I don’t want it!” Dean tries to shake Cas off.

“Dean, it’s okay. I’m applying deep pressure here…”

“I can’t do this right now!” He continues to struggle against Cas.

“…to relax…to relax your sympathetic nervous system. It’ll decrease your metabolic rate.”

Dean stills his movement and leans into Cas’ touch by wrapping his hands around the arms around him. He lets out a broken whimper.

“You’ll feel panicked at first. You’ll try to resist it-“ Dean squirms, “-you’ll try to resist it.”  
  
Dean whimpers again, “I don’t want this.”

“But eventually you will feel your pulse rate slow.”

“I don’t want this.” Dean still tries to squirm in Cas’ arms, now crying.

“It’s okay. It’s okay.” He soothes, “Your breath will come easier.”

“I don’t-“ He whispers.

“Okay. It’s okay, Dean.”

Cas eventually calms Dean down by bringing him over to one of the beds. He lies down and Dean wraps his arms around Cas’s torso like he was the anchor keep him steady. He sobs against Cas’ chest and Cas rubs his hand up and down Dean’s side, to let him know that he’s still there.

An hour or so later, Dean eventually falls asleep and Cas wraps his other arm around Dean to readjust his position so he could get some rest, too.

Sam had been asking around all over the hospital to found out where Cas was. A nurse had finally told him that he was inside an on-call room.

He barges in, knowing Cas is in there, “You are not going to believe-“

“Shhhh.”

Sam notices that Dean is draped over Cas’ body, sleeping. He looks up at Cas with a confused expression, “What are you doing?” He whispers.

“I don’t know.” He answers truthfully. “I just…I’m staying here.”

“Okay, then. Goodnight, Cas.”

Sam closes the door behind him and the sound causes Dean to stir in his sleep. He adjusts his arms around Cas and squeezes him a little bit tighter.

Cas smiles softly and runs a hand through Dean’s hair before kissing it.


	9. Before And After

**Notes for the Chapter:**

> Sorry that this is kind of a short chapter, but I've been working a ton lately and haven't had much time to work on this! More to come soon, though!

“We were just having dinner and he passed out.”

“Cassie, honey, I’m okay. It’s probably nothing.” Her father reassures her. “You should probably go grab some coffee while these nice doctors figure everything out.” He winks at her.

“Fine, dad, you win. You’re so stubborn sometimes.” She smiles and kisses his temple and walks out of the room.

The second she’s out of the room, “I have colorectal cancer. I’ve had five polyps removed in the last three years, and radiation. My daughter doesn’t know, and I’d like to keep it that way.”

“Umm, Dr. Novak, here, is gonna set you up for a C.T. with contrast.” Bobby says. “Where have you been treated? We’ll need to get your medical records.”

Just as Mr. Robinson is about to speak, Dean walks in and answers for him, “Columbia Hospital in Verona, and Dr. Shulty.”

Mr. Robinson stares at Dean, not at all happy to see him.

“I, uhh…I work here now. I saw that you were in and I thought I-“

“You waited until she left to come in and say hello. That’s just like you to face up to things like a man.”

Cas’ eyes flicker between Dean and Mr. Robinson, not quite sure what to make of what they’re talking about.

Dean sighs, “You should really tell her about the cancer, Mr. Robinson. She deserves to know.”

“You lost the right to tell me anything about her when you broke of your engagement in a two-line email.”

Cas stares at Dean, who is looking at the floor now.

“You ready to take him up, Dr. Novak?” Bobby snaps Cas out of this thoughts after watching Dean walk out of the room. 

“Uhh, yes. Of course.”

 

* * *

 

Dean approaches Cas a few minutes later out in the hallway, “Alright, Cas. You must have questions, so ask.”

Cas doesn’t look up at him, he just continues writing in the patient’s chart, “When was his last polypectomy? Since you’re familiar with the patient.”

Dean sighs, “That’s not what I meant.”

Cas looks up at him, “I know what you meant.” They stare for a few seconds and Cas breaks eye contact by looking down at the chart again.

“Cas, listen-“ Dean whispers.

“I have to get Mr. Robinson to his C.T.”

Just as Cas turns to walk away, Cassie is standing there holding a cup of coffee, “Hi, Dr. Novak.” She smiles. “The coffee here is-“ she pauses as she looks over Cas’ shoulder and sees Dean standing there.

“Dean?” She softly gasps. “I don’t understand. What-“

“I work here.” He softly answers.

“Wh-what do you mean? What do you mean?” She asks again, a little bit louder.

“Cassie-“

“When did you get back?” She walks towards him and Cas steps aside. “I-I just saw your mom. She didn’t say-“

Dean looks over at Cas, who can’t bring himself to look up at Dean.

“I thought you were in Iraq. I-I’ve been praying for you every night, Dean.” He voice breaks. “Every night I’m on my knees praying that y-you’re gonna make it back, that you’ll make it another 24 hours, that you’ll…” she sighs, “you’ll make it home.” She sobs and wraps her arms around Dean, “I’m so glad you’re back, Dean.” She cries into his shoulder.

He goes stiff against her. He doesn’t wrap his arms around her. He only lifts his hands to grab the arms slung across his shoulders and brings them away from him. He places her arms back down by her side and shakes his head and walks away. Leaving both Cas and Cassie standing there, staring back at Dean as he turns the corner.

 

* * *

 

“At some point you’re gonna have to tell her, Mr. Robinson.” Dean says as he goes over the patient’s chart.

“This is Cassie we’re talking about. She worries herself sick whenever anyone she cares about gets the sniffles. She can’t handle bad news. You used to know that about her.” He coughs.  
  
Dean shakes his head, “Well, she’ll find out eventually.”

Just as he goes to walk out of the room, Mr. Robinson coughs again and again until blood is pouring out of his mouth. Dean turns back around and places a tray under Mr. Robinson’s chin. “Dr. Novak!” He calls, knowing that Cas is just outside in the hallway talking to Cassie.

“What’s going on?” Cassie nervously asks as Dean, Cas and a few nurses rush into the room to take care of her father.

“Nurse, call the Chief and reserve and O.R.” Dean yells out.

“Dean!” She tries.

“It’s a…” he begins, “It’s a complication and he needs surgery.”

“But a-a complication? A complication from what?”

Cas stares at Dean, wondering what he’s gonna say.

He sighs, “He’s gonna be okay. I’ll keep you updated.” He looks up at Cas, who is pushing the patient’s bed out of the room, “Let’s go.”

 

* * *

 

“Let’s see here.”

“Is-is that a tumor?” Cas asks as Bobby and Dean open up Mr. Robinson for surgery.

“He’s gonna need more aggressive treatment.” Bobby says. “He’ll have to tell his daughter now.”

“He won’t.” Dean mumbles. “Her mother died when she was little. He feels that’s enough sadness for anyone, so…he sheltered her. She always had a nice car, nice clothes, anything she wanted.”

“Well, she’ll find out eventually.” Cas states.

“She used to call me in tears when there was a spider in her room. It became a joke between her dad and I. Neither of us could be out of town at the same time in case Cassie ever found a bug.”

“Well when he needs to go through chemo or gets so sick he needs hospice care, she’ll find out when it’s already over.” Cas looks up at Dean, “She deserves more than that.”

 

* * *

 

An hour or so later, Dean finds Cassie sitting in the waiting room.

He takes off his scrubs cap with a sigh and sits next to her, “It was a hard surgery. Some of the bowel was dead, as we suspected, but we were able to remove the diseased part successfully.”

Cassie looks at him, confused, but Dean continues, not making eye contact with her, “He’s in recovery and you can see him in about an hour.”

She nods, still not fully understand what is going on but, “You don’t even look like yourself.”

“Excuse me?”

“You don’t.” She shakes her head. “You look…hard. And…look, I-I know it wasn’t easy over there. I hear people come back and…I know you can’t just come back and be normal right away, but-“

Dean stands up, “He’ll be asleep for a couple of hours, but you can see him now.”

She looks up at him, holding back tears, “Two lines in an email? I deserve more than that.”

He looks at her, and builds another wall around himself, “Cassie, your dad has colorectal cancer. He’s already been through radiation treatment and polyp removals. He didn’t tell you…” he sighs, “because he didn’t want to burden you. He like to spare you any pain. Any more pain.” He nods and walks away, leaving Cassie alone to cry in the waiting room.

 

* * *

 

He searches the hospital for Cas and finds him talking with Sam.

He links his arm in Cas’ and tugs him away and Sam protests, “You never told him about Cassie?! What the hell, Dean?”

“Back off, Sam.” Dean warns.

“No way! You hurt my best friend and no one can get away with that.” He steps to pull Cas from Dean but Cas steps closer to him. “It’s okay, Sam.”

Sam stares back at Cas and he throws his arms up in exasperation, “Really? Just like that, you’re okay with this?”

“Just…wait, okay?” Cas silently pleads with Sam to let this go and Sam relents, “Fine. But I swear, Dean, if you pull something like this again, I will-“

“I know.” Is all Dean can say to reply and he tugs Cas away in the nearest on-call room.

Once he closes the door behind him he looks up at Cas, “I call her, okay?”

Cas gives him a confused expression.

“I call my mother once a week. I haven’t told her that I’m back. She thinks I’m calling from…” he waves his hand and sighs, “I keep the conversations short because I can’t bear for her to know that the son she sent off to war is gone. He’s gone.” He shakes his head. “And if I just got in my car and drove the six miles to see her, she’d be so sad, and she would look at me the same way Cassie does now-like I’m not there.”

Cas continues to look at Dean, but doesn’t say anything as Dean walks towards him.

“The only time I don’t feel like a ghost is when you look at me because you see me. You see me.” He takes another step towards him and now they’re standing so close.

He whispers, “This is me. Please, Cas, see me. See me.” He pleads and Cas looks up at him and softly smiles. Dean runs a hand through Cas’ hair and leans in for a kiss and Cas closes the distance between them.

It’s soft at first, and Dean tilts his head to deepen the kiss and Cas opens his mouth for him. He wraps his arms around Dean’s waist and pulls him closer.

There’s a knock at the door, “Dr. Winchester, you’re needed in the E.R.”

Dean pulls away with a growl and Cas is softly smiling at him, “Go. Save lives.”

Dean kisses him once more and walks out of the room, winking at him before the door closes.

**Notes for the Chapter:**

> I need an old girlfriend of Dean's for this chapter. So I chose Cassie. This may have been 100% OOC for her, but I don't really remember her all that well. :/


	10. An Honest Mistake

**Notes for the Chapter:**

> So, the name "Campbell" in this chapter has nothing to do with the Campbell's from SPN. It's simply the name of the character in Grey's. I thought about switching it to someone from SPN, but no one stuck out to me to use.
> 
> Sorry another short chapter. I'll try to not do it again.

“Fifty-two year old male, fell down a flight of stairs. He’s five days post-op from a cholecystectomy, which looks to have caused the fall.” Gabriel tells Dean and Cas while examining a patient’s bruised and broken ankle.

“Why would having your gall bladder removed cause a fall?” Cas asks.

“Well…” Gabriel begins as he leans in to lift up the patient’s gown, exposing his abdomen. A bruising and infected incision site is revealed.

“A non-laparoscopic choli?” Dean wonders. “Sir, what hospital did you have your operation at?”

“Here. Uh, my surgeon was Dr. Campbell.”

Cas sighs, “That explains it.”

“Uh, excuse us for a moment.” Dean says and he, Cas, and Gabriel walk away.

“Alright. Spill it.” He can sense the uneasiness between Cas and Gabriel when discovering it was Dr. Campbell.

“Campbell was Lawrence Grace’s first female surgeon, as pioneer as it gets. Mostly, she just sits in her office and spreads prestige around. She still does routine surgery now and then.”

“You mean botches routine surgery.” Cas adds, “I’ll page the Chief.”

“No, page Campbell. It’s her patient.” Dean says.

“And let her main the guy again? How about we page someone who actually knows how to operate instead of some dinosaur who refuses to retire her scalpel and go join her friends in Boca?” Cas deadpans and Gabriel laughs.

“The dinosaur is here.”

They all turn and look and see a woman, in her early to mid-sixties with thin blond hair pulled back into a neat bun and glasses on the bridge of her nose.

“Uhh..” Cas begins.

“No need, Doctor.” She hold up a hand, “Just show me to my patient.

“Of course.” He turns and they follow him up to where their patient is.

“Alrighty,” Gabriel begins as he examines the x-rays that were just given to him. “Well aren’t you a lucky little thing?” He grins. “You’ve only got a minor fracture, so you’re not gonna need surgery. You should be on your feet within a few weeks.” He grins.

“I don’t know what I was thinking.” The patient begins, “I knew the wound wasn’t healing as fast as I had hoped, but-“

“Next time, you call me, John.” Dr. Campbell interrupts. “Dr. Novak,” she turns to look at him, “explain to my patient what you feel I should’ve done differently in order to avoid this complication.”

“Now, don’t be shy, Dr. Novak.” She says after noticing his hesitation.

“Okay. Well, the patient’s status post minimally invasive procedures have been shown to have decreased post-surgical discomfort and recovery times.”

The patient stares blankly at Cas.

“In human, please, Dr. Novak.” She tells him.

“This surgery should have been done laparascopically.”

“Dr. Winchester,” she turns and looks at him, “perhaps you can explain to Dr. Novak why I chose to do the surgery this way?”

“Umm,” he clears his throat, “although some doctors prefer to use the new technology, there are others who believe it’s actually more risky since we can’t see or move around as much during the surgery. It’s…half a dozen either way.” He chances a glance at Cas, whose jaw is slacked in annoyance.

“Bravo, Dr. Winchester. Do you understand, John?”

“Yes. I have no doubt that you did the right thing by me, Dr. Campbell.”

“Wonderful!” She grins. “Now, Dr. Novak, please take our patient to C.T.-maybe you’ll learn something in the process-while I confer with Dr. Winchester about our course of treatment.”

 

* * *

 

Dean finds Cas in C.T. about 30 minutes later.

“Oh, done tending to Her Highness?” Cas jokes.

Dean laughs lightly, “You know, you’re tough on people. It’s good to hold such high standards, but this is medicine. No one’s perfect.” He sits next to Cas.

“She’s stubborn and out of touch.”

“So, her 40 years of experience means nothing?”

“Well, no, uhh, not if you don’t use them correctly. If she wants to be old and keep operating, fine. Just keep up with the medicine.” He sighs and leans back in his chair.

“Cas, this is one case. You can’t judge someone based on one case.”

“That patient deserves to know who his doctor is, no matter whose feelings it happens to hurt.”

The scan finishes and the image pops up.

Cas scoffs, “Laparoscopic or not, none of us should have made that mistake.”

 

* * *

 

“Mr. Terzian, your scans show a change from Dr. Campbell’s original assessment.” Bobby begins. “There was a complication from the surgery, a lacerated bile duct and artery. You’ll need another surgery to repair it.”

Dean and Cas look over at Dr. Campbell who can’t bring herself to look at the patient.

“Is that all?”

“Yes, that’s all.”

The patient exhales deeply, “Oh, thank God.”

Dr. Campbell looks up at him with a confused expression. Actually, Bobby, Dean, and Cas are all making very similar expression. Usually, patients aren’t this relieved to hear that they have to have another surgery.

“I thought that when they told me the Chief of Surgery was coming in, I was a goner for sure.”

Dean and Cas exchanges looks of confusion as Bobby continues, “We simply wanted to make you aware that it’s within your rights to request a change of surgeon.”

“Uh, Dr. Campbell’s not available?”

“She’s available.” Dr. Campbell answers.

“Oh, then no, thank you. I-I choose Dr. Campbell.”

“Very well. Dr. Campbell?”

“Thank you, Bobby.” She steps forward to stand beside the patient.

Cas follows Bobby out of the room, “Sir? With all due respect, I don’t think the patient’s entirely clear on what happened.”

“You heard the patient, Dr. Novak. He wants his doctor.”

“But, sir, she-“

“Back down, Novak.” He turns and walks away.

Dean approaches Cas and places a hand on his shoulder, “Cas-“

But he brushes him off and walks away.

 

* * *

 

In the O.R., Dean and Cas are assisting Dr. Campbell. After the surgery has begun, Bobby walks in to observe.

“Bobby.” She greets. “It’s been years since I’ve had you in my O.R. I seem to recall an incident involving a clamp being dropped into an open body cavity.”

Bobby laughs lightly, “You’re never gonna let me live that one down, huh?”

“A good teacher never lets up on her students. Although, I’ve often wondered how the upcoming classes learn anything with the way we teach these days.”

Cas looks up at Dean who shrugs in return.

“Attendings seem more concerned with inspiring their students, using encouragement and validation and so forth, instead of instilling them with the fear and shame that actually causes one to remember anything in the first place. Dr. Winchester, you come from the military. Wouldn’t you say the more rigid aspects of your training helped you become the doctor you are today?”  
  
“Yes, ma’am. Very much so.” He nods.

“Dr. Novak, on the other hand, well, something tells me that fear is not something you’ve often faced in the O.R.”

“I’d appreciate any opportunity to learn.”

“Wonderful. Let us begin, then. Tell me how you do a pulmonary embolectomy.”

“I’d insert a steerable catheter into the femoral vein, the position the fluoroscope adjacent to the embolus.”

“What would you do if the power should suddenly go out? Or if you had to operate in a hospital that couldn’t afford a fluoroscope?”

Cas doesn’t respond.

“Look, it’s like a calculator. Do you think just because there’s a machine to do it for them, children shouldn’t have to learn simple arithmetic?” She chuckles.

“It would help them avoid mistakes like this one.”

There’s silence for a few seconds. “Get out of my O.R., Dr. Novak.” When Cas doesn’t move she yells, “Get out!”

Cas removes his surgical mask and throws it on the floor, ripping the O.R. door open and slamming it behind him.

 

* * *

 

After the operation, Dr. Campbell, Dean, and Bobby are scrubbing out.

“Certain surgeries get the best of all of us.” She begins, “I made a mistake, a careless mistake…and for that, I am sorry. But I am only human-as human as any of us-and for that I do not apologize.”

“You don’t have to-“ Bobby tries.

“No need to discuss it further, Bobby. No need at all.”

Bobby finishes up and walks out of the room.

“I was fired...” Dean begins, “from the Army. They call it an Honorable Discharge, but…they knew it was my time even though I didn’t. I’m grateful to them for that.”

She stares back at Dean, unable to speak and he walks past her.

 

* * *

 

Cas finds Dr. Campbell sitting in her office a few minutes later.

“I would do a pulmonary arteriotomy-directly visualize the clot and use atraumatic forceps to extract it. That’s how I would do a pulmonary embolectomy without a fluoroscope.”

She sighs, “The fact that you felt the need to come and tell me that tells me that you’re a much better surgeon than I first thought. I’ve decided today’s surgery was my last. You look at me like you won’t wake up one day not that far from now-so much faster than you can imagine-and find that you are me. When you can’t cut anymore, what will you have? I was a god in this O.R. holding a scalpel. And now…what will you have?”

The smirk on Cas’ face disappears as Dr. Campbell walks out of her office.

 

* * *

 

Later on that evening, Cas and Sam head over to Joe’s for a drink.

Dean approaches them and sits a drink in front of Cas.

“I’ll, uhh…go get myself another drink.” Sam mumbles as he stands up from where he was sitting.

Dean sits next to him, “Today you were-you were a teacher to someone who needed to learn, but you were also a bully to someone who needed compassion. You were both.”

“Well, I wasn’t a bully and…I was right.”

“Right.” Dean chuckles.

“Of course.”

“You know, you’re a lot like her. Stubborn. Opinionated.”

Cas makes a noise of disagreement.

“And smart. Forty years from now, I’m gonna have to pry that scalpel out of your hand, too.”

“From my cold, dead hands.” Cas smiles.

Dean laughs lightly and leans into Cas, “You’re missing the point.”

Cas looks at him in confusion.

“I want to be around forty years from now, Cas.”

Cas smiles softly and leans in to kiss Dean.

 


	11. I Will Follow You Into the Dark

**Notes for the Chapter:**

> WARNING: Dean has his first PTSD episode towards the end of this chapter and it's violent. Just letting you know now.

The next few days have been good between Dean and Cas. They smile whenever they see each other, they try to have lunches together if their schedule allows it, they work several cases together, they sneak into an on-call room for a lazy makeout before napping together; things are great.

One morning, Cas is walking the hallway, checking on his patient’s charts when he sees Dean napping on one of the gurneys in the hallway.

He smiles and approaches him. Leaning over him, he rests a hand on Dean’s shoulder to gently wake him. Unfortunately, ‘gently’ is not how Dean wakes up. He sits up in a gasp, pure terror in his eyes, and shoves Cas off of him.

Cas goes flying back into the supply rack behind him, knocking everything off of it. Other doctors and nurses look on in shock as Cas cringes and looks down at his arm, now bloody and cut open.

Cas scoffs, “Uh, morning?”

“Oh, shit, Cas, I’m-“ Dean hops off the gurney and crouches next to Cas, “I’m-I’m so sorry. I didn’t mean to-“

“It’s alright, Dean.”

“No, it’s not! Shit,” he helps Cas stand up. “Here, let me fix that for you.” He tugs Cas into a room and begins stitching him up.

It’s quiet between them as Dean focuses on stitching Cas’ arm up. Faint sounds of nurses paging doctors over the PA and murmured conversations from the hallway filling the silence.

After a few moments, Cas speaks, “I dreamt once I was falling out a window hanging onto the drapes. I woke up pulling Sam’s hair out. Ha,” he tries to joke but Dean is silent, focusing on Cas’ arm. 

Seeing that that didn’t seem to help, Cas talks about work instead, “So, we have a trauma coming in. A tramping on a football field-“

“No, I don’t need your help today,” Dean interrupts.

“Oh, but I’m on your service today.”

“And I’m telling you, Dr. Novak, I want you to take care of that arm.” Dean stands up and begins to walk away.

“There you are!” Sam walks in. He looks down and sees the bandages wrapped around Cas’ forearm, “What the hell happened to you?”

“I tripped and fell. It’s fine,” Cas brushes off.

“No. No, it’s not,” Dean says, obvious hurt in his voice, and he turns to walk away.

Sam gives Cas a confused look.

“It’s…it’s nothing,” he says as he hops off the gurney, “it was an accident.”

Sam is skeptical, but relents, “Alright, if you say so.”

They walk out into the hallway, meeting up with Jo and Kevin, to wait for Ellen’s assignments for them for the day.

“Okay,” Ellen begins as she approaches the group. She checks her clipboard, “Tran, you’re in the clinic. Winchester and Novak, you’re with me. And Jo, honey, you’re in the Pit with other Winchester-“

“Oh, Dr. Harvelle,” Cas speaks up, “I’m supposed to be on trauma today.”

“Save it, Novak, Winchester wants Jo.”

Everyone turns and heads for their assignments, leaving Cas to pout in the middle of the hallway.

 

* * *

 

Recently, Jess has been going through some difficulties with her patients. She recently lost a pregnant patient while operating on a brain tumor and the patient’s husband is suing her and the hospital for malpractice.

Jess is refusing to operate on any more patients because of the depression she’s set into and it’s putting a strain on hers and Sam’s marriage.

 

* * *

 

 

Later on the day, Sam, Cas, and Charlie are all eating their lunches.

“And she just walked out of the hospital! Bobby was in the middle of talking to her and, without a word, she just walked out!” Sam says while stabbing at his salad with his fork.

“Dean won’t even look at me since he went all ‘Apocalypse Now’ on me this morning,” Cas mumbles as he sips on his coffee.

“She had to get all scalpel happy up in that patient’s brain, and now she can’t face it.”

“He thinks I’m, what, like this wilting flower? Well guess what? I’m the strong one!”

Charlie silently watches this exchange as she chew on her lunch, smile on her face.

“I’m being strong here,” Sam continues.

“I’m the strong one. I face things and I don’t walk away.”

“Jess walks away. Maybe walking away is the answer.”

“See, it’s not emotional. It’s science. You have a problem, don’t ignore it.”

“Well, sometimes if you have to pee and you ignore it, it does go away.”

Charlie laughs, “You guys are hilarious.” Sam and Cas look over at her, confused.

“I mean, do you even know what he just said?” She asks, pointing to Cas, “Or what he just said?” She points to Sam.

Sam and Cas look at each other.

“I can totally see you guys in fifty years in a nursing home, just talking at each other with your hearing aids off,” she laughs again, “Hilarious.”

 

* * *

 

Later on that evening, Dean is sitting at one of the nurses’ stations, typing on the computer when Cas approaches him and shoves him aside.

Dean scoffs, “Wh-What are you doing?”

“Assigning myself to a trauma with you tomorrow.”

“Cas, you-“

“You know,” he turns to look at Dean, “I’m a big boy. I can handle my share of trauma. And I get to decide when I’ve had enough.” He sighs, sitting next to Dean, “It’s going to take me a lot more than a bad dream to scare me off.”

Dean reaches in and grabs Cas’ hand, “It’s more than a bad dream,” he whispers.

Cas runs a hand through Dean’s hair and caresses his cheek, “I know,” he says softly. 

 

* * *

 

Sam and Jess continue with their fighting about how Jess won’t come back to work at the hospital. He and Cas are walking down the hallway and he decides to vent about it.

“It’s the not knowing if she’s okay. Like, I don’t know how she’s even doing with all of it. She won’t talk to me, nothing. We live in the same house, we sleep in the same bed and still nothing from her,” he sighs and looks over at Cas who is absent-mindedly walking next to Sam while looking down at his phone.

“You’re not even listening to me, are you?”

“Uh, sorry,” Cas looks up from his phone.

“No, no. That’s okay. I get it. You’ve got your first solo surgery today and you’ve got Dean. It’s a charmed life. You don’t have time for me,” Sam jokes.

“I have not ‘had’ Dean. We’ve only…kissed a couple time. It’s like friends with benefits,” he frowns, “without with benefits.”

“Still no sex?” Sam laughs.

“I’m not talking about my non-existent sex life with your brother with you,” Cas laughs, “but…no. Still no sex. Not a charmed life,” he laughs.

 

* * *

 

Ellen is sending anyone who is willing to go out to Sam and Jess’ house to try and bring her back to work. She sent Gabriel out earlier in the day but he never came back so she finds Dean and asks if he is willing to go out there.

“Uh, yeah. I can try,” he begins, “but, Sammy’s told me about all of it and I don’t know what I can do.”

“Just try,” she tells him.

 

* * *

 

Dean arrives at Jess’ house and sees her and Gabriel sitting on the front porch drinking beers.

Jess tosses Dean a beer and he catches it before sitting down with them.

Gabriel and Jess were swapping stories about the different patients that they have lost and they ask Dean to share one.

"I was a second-year resident and an M.V.C. rolls in. Parents were in the front seat, three kids in the back. Kids were okay. Mom and dad were a little banged up, but nothing terrible. They were talking and laughing in the E.R. Turns out both parents had massive internal injuries. I operated on them both that night. Took me hours and I…I lost 'em both," he sighs and takes a swig of his beer, "You know, if I had moved faster, if I had rushed them to C.T., if I had known how bad off they were sooner…but I didn't. The oldest kid was nine. When I came out to tell 'em about their dad, he was trying to console the three year old and the five year old about their mother. I'll never get that image out of my head - this nine year old boy trying to hold these two little ones, and his arms were just not big enough. I don't know how I came back the next day," he sighs, "I think part of me never did."

“I’m surprised you didn’t talk about Iraq,” Jess simply says.

“I don’t have talk about Iraq,” Dean snaps. “What my point was, you know, I went back. I showed up. I showed up for work, you know?”

“Or you go dead inside,” Jess says, “You go Dean inside because if you let yourself feel that? No way you’re going back. No way.”

He sighs and sits back in his seat as Gabriel hands him another beer.

 

* * *

 

Dean goes back to the hospital later that evening and finds Cas and Cas is able to tell that something is kind of off with Dean.

“Hey,” he says softly after he pulls him into an on-call room. “You look like you’ve had a rough day. Why don’t you come by my place tonight? I’ll make dinner, we can watch tv?”

Dean smiles softly and grabs onto Cas’ wrist, “I’d like that,” he whispers.

“Good,” Cas smiles, “Listen, I’ve got to go and do my surgery but, come by tonight around 7.” He kisses his cheek and walks out of the room.

 

* * *

 

Dean knocks on Cas’ door a little bit after seven and Cas opens the door with a smile, “You’re not late and you’re not drunk. Very impressive,” he jokes.

“Yeah, yeah,” Dean smiles softly as he walks into the apartment.

Dean brought a six-pack of beers and they split it over dinner. It wasn’t anything fancy, just spaghetti and salad.

“That was delicious, Cas,” he smiles and they both get up to clean their dishes.

They end up sitting on Cas’ bed, leaning back against the headboard as they watch videos of various surgical procedures.

“So this is how you unwind? By watching two hours straight of advanced carotid endarterectomy?” He laughs as he still stares at the screen. “Cas?” He looks over at where Cas is lying and sees that he has curled up into a little ball against Dean’s side, asleep. Dean smiles and turns off the tv and pulls the covers over them both. He props himself up on one elbow to look at Cas as he runs his fingers through his hair, leaning in to kiss his forehead.

He rolls over and turns the lamp off and lies on his back with a contented sigh as he stares up at Cas’ ceiling fan slowly spinning around in circles, and he drifts off to sleep.

The slow spin of the ceiling fan triggers Dean’s PTSD via nightmare and vivid hallucinations and begins choking Cas in his sleep.

Cas is lying beneath him, gasping for air, struggling against Dean’s fingers wrapped tightly around his neck. He reaches over at his bedside table for something to grab onto but everything falls from it. He continues gasping as he stares up into Dean’s lifeless face. He claws at Dean’s face, he tries everything but Dean’s grip around his neck squeezes even tighter.

The noise of Cas’ gasps and things crashing onto the floor wakes Gabriel up in the next room over and he knocks on Cas’ door, “Is everything okay in there?” He knocks again when there’s no response, “Guys?” He asks as he opens the door and gasps when he sees Dean over Cas and Cas thrashing beneath him.

“Cas! Dean!” Gabriel rushes in and pushes Dean off of Cas.

Dean goes flying to the floor as Cas scurries into his bathroom, gasping and choking as he tries to catch his breath.

Dean wakes up from his nightmare, gasping, “What-what…” he looks around and sees Gabriel standing above him and he can hear Cas sobbing in the bathroom.

Gabriel takes the time to call Sam and Sam answers the phone, groggy, “It’s three in the morning, Cas, this better be-“ he pauses, “Gabriel?”

He listens as Gabriel explains and sits up in his bed, “What? He what?!”

About 15 minutes later there’s a knock on Cas’ bedroom door. “It’s me,” Sam calls, “Cas?”

Cas stands up and opens the door for Sam and walks back over to the mirror.

“What’s going on? Dean is out there upset. Gabriel was yelling, he said-“

“No changes in visual acuity. No petechiae. I’m fine. I-I’m fine,” he turns around to look at Sam.

“Oh my god, Cas. Your neck! I will kill him! He’s-“

“No, no, no. It was a nightmare. He had a nightmare.”

There’s a knock at the bathroom door, “Cas?” Dean calls softly, “Please. Is he alright, Sam? I just need to know that he’s alright.”

Cas takes a step towards the bathroom door and Sam stops him, “No, no, no, no, no. Cas,” he steps in front of him, “No.”

Cas just pushes Sam aside and opens the door to see Dean with tears stained on his cheeks.

“I am so sorry,” his voice shakes, “I don’t know what happened. I don’t remember,” he lets out a sob, “I don’t know what happened. I’m sorry, Cas. Please.”

“Look at me,” Cas says.

Dean hesitates and shakes his head as he looks down, “I’m sorry, Cas. I-“

“Look at me,” Cas says, firmer.

Dean finally lifts his eyes to meet Cas’.

“I’m fine. See? It’s okay. You were asleep,” his voice breaks, “It’s okay, Dean. Okay?” He leans in and wraps his arms around him.

Dean sobs into his shoulder, “Cas, I’m so sorry.” He wraps his arms around Cas’ waist.

“It’s okay. I know,” Cas says softly as he pets the back of Dean’s head.

 


	12. Stand By Me

**Notes for the Chapter:**

> Dean has a very minor PTSD episode in the beginning of this chapter. It's not violent at all. But the imagines that pop into his head are negative so I just thought that I would warn y'all now before you read it!  
>   
> NSFW at the end of the chapter!  
>   
> Also, I know that Sam in this is kinda being a horrible and dickish brother to Dean and I'm so so sorry about that. I kinda wrote myself into a corner there and didn't really feel like re-writing any of it to fix it. But, I promise that I'm not approaching the brothers' relationship in a negative way. It'll all work out in the end, I promise.

Later on that same morning, Cas busies himself with checking on his patient’s charts, making sure that none of their numbers got worse over the night. Sam approaches him and sighs, “You’re wearing a turtleneck under your scrubs, dude. It’s ugly,” he looks down at his own charts, “Not as ugly as the fact that you hugged him,” he looks over at Cas, “You hugged him-“

“I get it. I hear you. Move on,” Cas responds, still looking down at his charts.

“Turtlenecks aren’t okay. You’re not okay. Dean’s not okay.”

Cas sighs and closes his charts, “Let’s move on, Sam,” he walks away.

Gabriel approaches Sam, “Is he doing okay?” He gestures towards Cas who is down the hall, talking with his interns.

“Yeah, well. He says he is,” Sam sighs.

“Do you believe him?”

“No,” he looks over at Cas, “Not really.”

“Oh, heads up,” Gabriel nods his head in the direction where Dean is coming from as he walks towards Cas.

Sam steps out in front of him to stop him.

“What are you-“ Dean protests.

“You don’t get to talk to him right now, Dean. Look, you’re my brother, and I love you, but Cas is my best friend. Just…stay away from him for a while, alright? Give yourself a chance to think about things.”

Dean scoffs and looks over at Gabriel, who is giving him a dirty look.

“Yeah. Okay,” Dean sighs and walks away.

 

* * *

 

Later on that morning, Dean finds himself on the roof of the hospital awaiting an incoming trauma being airlifted to the hospital.

Bobby meets him up there, “What’d you hear?” He calls out over the sound of the helicopter landing.

“Motorcycle lost control, no helmet. Massive head trauma. Lost vital signs en route,” he calls back.

As the helicopter lands, Bobby rushes over to it and Dean freezes. Every noise around him becomes muffled and he begins to breathe heavily. The only thing he notices is the faint sound of the helicopter blades whooshing above him and he begins slightly panicking.

He instantly finds himself back in Iraq, tending to mangled bodies everywhere. Saving those he can and seeing others die that he can’t. The sounds of helicopters above and guns firing all around him drown out the sounds of soldiers crying out for God to save them.

Dean gets brought back to reality by Bobby slapping a hand on his shoulder, “Let’s go, Dean. He’s D.O.A.”

Dean continues breathing heavily.

“Dean? Do you hear me?”

Dean shakily nods his head and follows Bobby back inside.

 

* * *

 

Sam and Cas make their way over to the cafeteria for some lunch.

“There’s no way that Swenders could pull that off,” Cas laughs as he talks with Sam about another doctor, “He has no vision! Plus, he-“

“He wrapped his hands around your throat this morning and you’re acting like nothing happened.”

“Sam,” Cas sighs.

“Dean literally tried to kill you, Cas. He’s barely back from Iraq. It’s obvious that he has issues. But that doesn’t mean that you have to stand by and-“

“Okay, so what? If he had a heart attack, or a stroke, or lost a leg, would you walk away? So, how is it any more acceptable that I walk away from this? He’s wounded. He has war wounds, Sam. It’s not cut and dry, and it’s not as bad as you think it is.”

 

* * *

 

Jess has finally decided to come back to the hospital. It took a lot of convincing from Sam and the hospital was about the fall apart without its neuro-attending.

“Hey, Jess,” Dean smiles at her.

“Oh! Hi, Dean! I’ve actually been meaning to catch you.”

“Yeah?” He sits with her on a bench.

“Yeah. So, you know, they’re doing tests now that show altered brain anatomy in patients with PTSD. They’re actually getting close to understanding the physical side of the psychological injury. It’s amazing what you can see with an M.R.I.”

“What did Sam tell you about last night? What did he say?”

“Post-traumatic stress is a real injury, Dean. It can be healed. There are resources, vet centers, therapy. You shouldn’t try and handle this on your own.”

Dean looks down and shakes his head, “I came back in one piece,” he sighs, obviously irritated, “I have both arms, both legs. Lots of guys come back with real injuries. If the worst I have is a couple nightmares or if I freeze for a moment-“

“Is that what happened last night?” She raises her eyebrow at him, “You had a freezing moment? Those claw marks on your neck suggest otherwise," she nods her head towards Dean's neck and he bring his fingers up to lightly trace over them. "Look, if you want, I can help you, Dean.”

Dean scoffs, “Oh, yeah? Well, I’m not the one who needs help around here. I’m not the one who cut out half a woman’s brain and then ran off to hide. I’m not the one who half this hospital is talking about behind their back. So maybe you should spend a little less time worrying about me and, you know, take a look in the mirror, alright?” He gets up and walks away.

 

* * *

 

Dean heads down to the room in the basement of the hospital with the air vents. He brought Cas here once, a while ago, and it’s the best place in the hospital he can go to clear his head and organize his thoughts.

Cas finds him down there and he walks into the room, closing the door behind him, “I haven’t seen you all day,” he says softly.

Dean shakes his head, “What if I hadn’t woken up?” He pauses and looks over at Cas, “I can’t even remember what happened. It’s gone. I have no memory, no way to…” he trails off, breathing heavily. He looks down at the ground and shakes his head. He looks back up at Cas and takes a step towards him, “I would never hurt you. Ever,” he pauses, “But I did. My hands just…” he looks down at his hands, “How could my own two hands be capable…” he scoffs, “I can’t do this, Cas.”

“But you did wake up,” Cas takes a step towards him, “Stop blaming yourself.”

“We have to stop seeing each other,” Dean talks over him.

Cas continues walking towards him, “Why?”

“Cas, I almost-“

“Almost what?” He pauses, inches from Dean’s face, “I told you, I know my limits. Let me decide what I can handle.”

Dean sighs and leans in to kiss him but Cas presses a hand against Dean’s chest, holding him back. They look into each other’s eyes for a few moments in silence before Cas turns away and walks out.

 

* * *

 

Dean and Cas don’t see much else of each other throughout the day due to their busy schedules. Cas finds Sam talking with Charlie and he approaches them, “Have either of you seen Dean?”

Sam scoffs, “Cas…”

“Don’t, Sam. He’s your brother and he needs you to be there for him.”

“Well, yeah, but-“

“You know for a fact that if it was the other way around that he would be doing everything he could to make sure that you’re doing okay. As much as I appreciate you being a good friend to me, you need to go and be a good brother to him. Let me take care of me and if I need you to kick his ass, then I’ll let you know. But until then, please.”

Sam sighs and points down the hall, “He’s in one of the on-call rooms taking a nap.”

Cas nods and walks away.

Charlie scoffs, “He’s right, you know,” she smiles at him.

“Yeah, yeah,” he playfully nudges at her.

 

* * *

 

Cas softly knocks on the door and then lets himself in.

Dean sits up from the bed he was lying on and looks over at Cas, “Hey.”

“Hi,” Cas says softly. “My surgery went well today,” he smiles.

“Good. Yeah, that’s…good,” he pauses, and looks up at Cas, “I wish that things were…I wish that we could be…”

“Me too.”

Dean stands up and fidgets with his arms at his sides. After a minute or so, “Can I…can I hold you?” he asks, barely above a whisper.

Cas takes a few steps towards Dean and Dean instantly wraps his arms around Cas’ waist, pulling him even closer. Cas throws his arms around Dean’s shoulders and rests his forehead against Dean’s.

Dean places a soft kiss on Cas’ forehead and slowly moves down his cheek to his lips and he softly presses his lips against them. Cas kisses him back by parting his lips and meeting Dean’s tongue with his own.

Dean moves to take his own scrub top off and Cas helps him by pulling it over his head and throwing it across the room. They move on to Cas’ top and Dean pulls it over his head, with the turtleneck attached. They’re shirtless and Dean pulls Cas into him so they’re bodies are pressing together. He leans down and kisses him once more before moving down his jaw to his neck.

Dean pauses his kisses when he notices the bruises that have formed on Cas’ neck. He looks into Cas’ eyes with such a sadness that Cas can’t help but kiss it away, “It’s okay,” he whispers.

Dean kisses him back, hard and pulls him down to one of the beds. He runs a hand through Cas’ hair as he looks down at him with such reverence and awe. Cas runs his hands up Dean’s sides until they’re in his hair and he pulls him down for another kiss.

They take their time pulling their scrub pants off and their boxers and discard them along with their tops across the room.

Now naked, Dean lies above Cas, pressing their erections together and he thrusts once. Cas lets out a soft gasp and Dean captures his lips with his own, swallowing any noise the other man has to offer.

He thrusts a little bit more before taking both of their erections in his hand, “God, Cas….” He breathes into his mouth before kissing him.

Cas hums as he rocks his hips up into Dean’s and peppers open-mouthed kisses along his neck, “Dean…” he whines.

Dean looks down into Cas’ eyes, and Cas gives him the silent nod of approval before Dean runs his hand down Cas’ side, under his leg and pushes it out, he slicks up one of his fingers with his own saliva before pressing it against Cas’ entrance.

Cas hisses at the intrusion but relaxes and Dean’s finger easily slides in, “Oh, fuck…” he moans, “Cas…” he captures Cas’ lips with his own before pumping his finger in and out a few times. He adds the other very slowly as he runs his fingers through Cas’ hair, willing him to relax.

After the third finger is in, Cas begins feeling impatient, rocking his hips on Dean’s fingers with breathy moans and Dean smiles at him, “Are you ready?”

Cas whimpers and nods and Dean leans down to kiss him once more as he lines his cock up and slowly presses in. Dean groans at the sensation and Cas wraps his arms and legs tightly around Dean, urging him on.

The sounds of their breathing and skin slapping against skin fill the room as they each work their way towards their climax.

Dean rests his forehead against Cas’ and looks down into his eyes, “You’re so amazing, Cas,” he breathes, “So…so fucking amazing,” he runs his hand through Cas’ hair, tugging slightly on it, “Amazing…” he breathes.

Cas closes his eyes and throws his head back in a groan, “Ahh…Dean…I’m gonna…”

“It’s okay,” Dean whispers, “you can let go, Cas. I got you,” he picks up the pace of his thrusts, “I got you…” he whispers into Cas’ ear.

Cas arches his back with a cry and spills his release all over his stomach and Dean leans down to kiss him.

“Oh, Cas….Cas…” Dean chants as his thrusts become staggered and uneven and he shortly follows Cas, spilling his own release inside of him.

Dean lies on top of him, and they wrap their arms tightly around the other as they ride out the aftershocks of their orgasms.

Dean eventually slides out and rolls onto the side, pulling Cas in tight against his chest. Cas finds the blankets down by their feet and brings them up to cover them.

Dean lies there, watching the steady rise and fall of Cas’ chest as he stares of at the ceiling, arm draped over his forehead.

After about thirty minutes, Dean drifts off to a light sleep and a tear streams down Cas’ face, “I don’t think…” Cas begins, “I don’t think that I can handle this after all,” he voice shakes as he continues to stare up at the ceiling.

Dean blinks his eyes open and sits up slightly, “What?” He whispers, “What do you mean?”

“I’m sorry. I’m so, so sorry, Dean,” Cas whispers as another tear streams down his face, “But I’m lying here in your arms, and I’m afraid to fall asleep.” He wiggles his way out of Dean’s arms and sits up on the bed.

Dean sits up, too, his face etched with hurt and brokenness, “I can’t undo what I did, Cas,” he whispers, “but I don’t want to ever hurt you again. Never,” he reaches a hand out towards Cas but stops and brings it back to his lap.

“I’m sorry,” Cas whispers as he stands up from the bed and puts his clothes back on. He walks out of the room without another word to Dean.

 

* * *

 

About an hour later, Dean finds Jess and he gives her a silent and broken nod.

Jess, being the smart woman that she is, knows exactly what Dean is talking about and ushers him over to get an M.R.I.

As Dean lies on the table, ready to begin the scan, he looks up at Jess, “Listen, I wanna apologize for earlier. What I said was…it was out of line.”

“It’s already forgotten,” she smiles down at him.

“Thank you for doing this.”

She silently nods her head and begins the scan.

 

* * *

 

Cas finds himself back at his apartment, lying on his bed as he watches his ceiling fan slowly spin in circles, tears staining his cheeks.

There’s a soft knock on his door and he doesn’t have to look to see that it’s Sam walking in.

“Hey,” Sam greets softly.

Cas sits up in his bed, “I broke up with Dean,”

Sam nods his head and grabs two beers out of his backpack. He cracks them open and hands one to Cas as he sits with him on his bed.


	13. Sweet Surrender

**Notes for the Chapter:**

> WARNING: a minor character in this chapter is suicidal and makes an attempt

The next few days at the hospital are tense between Dean and Cas. Their brief moments of interaction consist of only longing stares from across the hallway, mostly from Dean. Cas is trying his best to distance himself because the sight of Dean, hurt and broken because of him, is too much for him to handle.                           

“I don’t feel anything,” Dean says as he talks to Dr. Moseley, the hospital’s psychiatrist. Dean has been meeting with her to help him express his emotions and recognize what triggers his PTSD; the blades Cas’ spinning ceiling fan simulating a helicopter’s blades, being one of them.

“Nothing?” She raises an eyebrow, “No anger? Happiness? Unhappiness? Guilt? Survivor’s guilt? You know, it’s very common in veterans.”

“It’s not about my platoon.”

She leans forward in her chair, “You have shoved your feelings aside for so long. I’m asking you to claim them. And, yes, Dean, this is about your platoon.”

Dean scoffs, “It’s about the fact that I tried to choke my boyfriend to death. What, are you saying the way I feel about my platoon and the way I feel about what happened with Cas are the same? They’re not the same.”

“Well, how will you know if you can’t name those feelings?”

“That’s not what it’s…” he shakes his head, looking at the ground, “It’s not…” he sighs, “I don’t know.”

 

* * *

 

“You paged me?” Benny asks as he meets up with Dean in the E.R.

“Yeah, uh, driver’s face went through the side window. I thought it would be your cup of tea.”

Benny smiles, “Right you are, brother.”

They head out to meet the ambulance.

“What do you got?” Jess calls out to one of the paramedics.

“Anthony Meloy, 32-year old male pedestrian with a left arm injury and road rash to his face and torso. Stable vitals. Landed on the street after he was hit by the driver.” They wheel him out of the back of the ambulance and Jess begins examining him.

“I didn’t hit him,” a slurred voice comes from their left, “he jumped in front of me!”

The second paramedic comes out of the other ambulance, wheeling another gurney, “Dan Gates. Swerved after he _didn’t_ hit Mr. Meloy and sideswiped a telephone pole. Complains of abdominal pain. He also has blood coming out of his left ear-“

“He came out of nowhere!” Mr. Gates yells, “It’s not my fault!”

“You better give that son of a bitch a blood alcohol test. He was driving like a madman!” Mr. Meloy says.

“Now he’s just lying.”

“Oh, I’m lying?!”

They continue to argue as the doctors continue to examine them.

“Mr. Meloy try to stay still,” Dean says.

“No sigh of head trauma,” Jess says as she clears Mr. Meloy.

“Check out the other guy. I got it from here. Let’s go.” Dean says as he begins wheeling him into the hospital.

 

* * *

 

“I was just driving to the bank,” Mr. Gates says as Benny, Dean, and the other doctors tend to his injuries. “The next thing I know is this guy jumping in front of my car. Fucking whack job.”

“He’s got free fluid in the upper quadrant,” Dean says, “Milligan, schedule a stat C.T.”

Dean makes his way over to the other patient, “How are we doing, Mr. Meloy?”

“My arm’s killing me. But otherwise, I’m fine.”

“He’s got tenderness and bruising over his humerus, but good pulses,” Adam responds.

“We should still do a full work-up. Milligan, check in with Kevin once you assess, let him know what you find.

“Okay,” he says and gets to work.

 

* * *

 

Jess checks Mr. Gates’ C.T., “There’s no blood in the brain.”

“ZMC fracture of the temporal bone, ruptured eardrum. Book us an O.R., Adam,” Benny smiles.

“Uh, not so fast, Dr. Miligan,” Jess calls out to him, “Mr. Gates has an injured facial nerve. Which means?”

Adam sighs, “That Mr. Gates will also need a nerve repair.”

“Does that take place before or after Dr. Lafitte’s ossicular reconstruction?”

Adam sighs and walks over to look at the scan. After a brief moment, he answers, “Before.”

“Incorrect,” Benny protests.

“Because you’ll have to explore for bone fragments, not to mention, reversing his hearing loss,” Adam says.

“Which is why I need you to book me that O.R.”

“Look,” Jess interrupts, “If he has facial paralysis, it’s not gonna matter if he can hear out of one ear, right, Dr. Milligan?”

Adam sighs, “Right,” he turns to walk away before he can be pulled back into whatever competition Benny and Jess have going for themselves.

 

* * *

 

Jo is down with Mr. Meloy, “You said that the car hit you while you were in the crosswalk?”

“Yeah. Are you almost done? Cause, I, uhh, I need to go,” He fidgets in his seat.

“Uh, no. Umm…” she looks around the E.R. for Kevin and finds him. She looks back at him, “Because we need to wait for the police. They need a statement.”

“Is that really necessary? Can’t I just leave my name and phone number?”

“I just need you to wait here for one more minute, okay?”

“Yeah,” he mumbles.

“Thank you,” she smiles and pulls the curtain closed. She walks over to Kevin, “Dr. Tran, I need to order a psych consult for Mr. Meloy. He said he was walking when the car hit him, but the pattern of his injuries aren’t consistent. Plus, he’s acting a little agitated.”

“Maybe because he was just hit by a car. You need to discharge him because we’ve got a lot of other patients with worse injuries.”

“If he leaves, and he hurts himself. That’s on you, Kevin.”

Kevin sighs, “Fine. Get your consult. But if someone in that waiting room dies because there wasn’t an open bed for them, that’s on you.” He turns and walks away.

 

* * *

 

Jess, Benny, and Dean are back with Mr. Gates.

“You have damage to your facial nerve from a broken bone behind your ear,” Jess says.

“Which I’ll repair,” Benny speaks up and Jess scoffs.

“You also have some bleeding around your spleen,” Dean says, “We’ll keep an eye on it.”

“Also, your eardrum is ruptured. You might lose hearing in your left ear.”

Mr. Gates scoffs, “Unbelievable. That is unbelievable. That son of a bitch!”

“Mr. Gates, it’s important that you try and stay calm,” Jess tell him.

“No, don’t tell me to stay calm. That son of a bitch dove in front of my car. He actually dove! Like he was Superman! He had his arms stretched out and everything!” He sighs, “I was going to the bank. I was just…” his voice shakes, “going to the bank.”

Mr. Gates' story resonates with Dean in a way that makes him rather upset. He shoves those thoughts aside and walks out of the room.

“Kevin? What are you doing up here?” Dean asks when he sees him walking around one of the nearby hallways.

“I just stopped to check in on one of my patients. I’m on my way back down to the E.R."

“What happened with the pedestrian? Did the cops talk to him?”

“I don’t know. I-I don’t think so.”

“You don’t know? That guy may have tried to kill himself."

“Uh, I called for a psych consult.”

“You have a potentially suicidal patient and you’re up here wandering around? Are you aware that the guy who hit him is heading to the O.R.? He’s in terrible shape!”

“I-“

“Quiet!” Dean yells at him. Nurses and other doctors around begin to notice their conversation. “If that guy intentionally threw himself in front of that car, he should pay. He should pay! He better not walk out of that E.R.!”

Kevin turns around and walks away.

“Move faster, Kevin!” Dean yells after him and Kevin takes off running.

The staff gathered around him stare and whisper to themselves and Dean notices. He sighs and walks away.

 

* * *

 

“You ordered for a psych consult?”

“Uh, yeah,” Jo answers the doctor.

“Where is he?”

“Wha-“ Jo walks over to the bed where Mr. Meloy was an sees that he isn’t there, “Shit…” she whispers under her breath.

“Wonderful,” the doctor laughs, “you lost him.”

“I have not-Have you checked the waiting room?” Jo walks towards the waiting room.

Kevin calls for her, “Harvelle! Where’s Mr. Meloy?”

Jo turns around, “Psych was supposed to be examining him and he’s not my only patient, Kevin!”

They find their way outside of the hospital, looking around for him.

“Oh, great! You lost him! Dean is really gonna love hearing about this!”

“You didn’t want the psych consult!” Jo spits back at him. “I don’t get it. I just…I don’t understand-“

“Don’t understand what? You don’t understand me? Well, I’m not the one who turned my back on a guy who I thought was suicidal! That’s not on me!” Kevin yells.

There’s faint thudding coming from one of the windows above them. They both look up and can hear the glass cracking as something continually thuds against it, trying to break it open.

The glass finally breaks free and they see someone hurling themselves out of the fourth floor window. It’s Mr. Maloy. He lands on top of one of the cars, denting it in severely and Jo and Kevin rush over to him.

Doctors rush in to remove him and set him on a gurney and they wheel him into the hospital.

Dean meets them, “What happened?”

“We did ALTS protocol, but he’s, uhh-“ Kevin stammers.

“We inserted bilateral chest tubes,” Jo steps in, “but he kept on bleeding out. Then he started bradying down so we pushed atropine. I opened his chest when we lost vitals and found a jagged edge of a rib protruding into his ascending aorta, so I attached a clamp and I’m getting some heart activity.”

“You got an O.R. lined up?” Dean asks.

“O.R. two,” Jo responds.

“Good work, Jo. Scrub in”

 

* * *

 

Both Mr. Maloy and Mr. Gates survive their surgeries and at the end of the day, Dean finds himself back in Dr. Moseley’s office.

He sits on her couch, fidgeting with his hands, bouncing his leg up and down, and is silent for a long time. He’s angry.

He tries to speak but stops himself and clenches his jaw. He lets out a frustrated groan.

“Dean?” Missouri tries.

“I jumped…in front of his car…and he was just driving to the bank,” he says softly.

“We’re talking about Castiel?”

“I jumped in front of him. I knew. I knew I wasn’t together, I knew I was no good for him, or for anyone,” he pauses, “and I wrecked him. And that…is unforgivable. I don’t forgive myself for that,” his voice breaks, “I can’t forgive myself for that. And I’m feeling shameful about that.” He pauses and looks down at his hands, clenched in tight fists as they rest in his lap, “That is what I feel today. Shame.”

“Good,” she says softly and Dean flinches. “That’s a start.”

“How is that a start?” Dean scoffs.

“You named it. The feeling. You have to know what it is before you can start to navigate to somewhere better."


	14. One More Chance

**Notes for the Chapter:**

> Hopefully this helps with getting things on track between Sam and Dean.

“Whose service am I on today, Dr. Harvelle?” Sam greets her the following morning.

“Uhh, you’re with your brother today in the Pit.”

Sam scoffs, “You can’t be serious.”

Ellen shifts her weight to her other foot and points a finger at him, “Boy, you listen to me and you listen real good. You need to get over whatever little issue you’ve got with Dean because it’s effecting everybody. Now, shut up and get your ass down to the Pit before I kick it there.” She stares at Sam with one eye brow raised.

Sam sighs and walks away.

Dean is the first to greet him once he’s off the elevator, “Hey, Sam,” he sets his clipboard down, “Uhh, we’ve got a trauma coming in with multiple GSWs to the chest and abdomen. Page Kevin to come help, too.”

“Yeah, okay,” Sam walks away and prepares for the trauma.

Dean watches him walk away and he shakes his head, “Sam?” He calls.

Sam turns around with an exaggerated sigh, “Yeah?”

Now, Dean can handle a lot of Sam’s bullshit – he’s dealt with it his whole life –he’s used to just ignoring him and letting him work it out on his own. But, things are going to be handled a little differently now because his shrink is advising him against holding onto grudges and swallowing his emotions.

He looks around the crowded hallway then nods his head in the direction of the stairwell, bidding Sam to follow him.

Sam walks in behind him and closes the door, “What, Dean? We’ve gotta get to the trauma that’s-“

“No,” Dean holds a hand up to stop him, “I get to talk now,” he sighs, “I, uhh, I want to talk about…us and I was wondering if you wanted to grab a beer after work?”

Dean has never been the kind to want to talk things out like this so he’s seeing it as a good sign that Dean is actually, _hopefully_ , working towards getting better. “Yeah, that’s, umm, that’s a good idea. I think it’ll be good to, you know, talk,” he smiles softly.

Dean laughs lightly, “Good. Umm, yeah, let’s go. We’ve got that trauma coming in.”

Sam walks out first, passing Cas, “Hey,” he smiles at him.

Dean walks out second and bumps into Cas. “Sorry. I’m sorry,” he says.

“Sorry,” Cas says, almost at the same time.

They stand for a few seconds staring at each other and it’s a little awkward and Dean finally says, “Take care, now,” and walks away with a smile.

Cas is a little put off by this but walks away eventually.

 

* * *

 

That same patient with the multiple GSWs has been rushed into surgery and Cas is in there with Kevin, Sam, and Dean.

“Damn it. Too many bleeders,” Dean says as a stream of blood falls from the patient. He grabs pads from one of the nurses to help soak it up, but it doesn’t work. “Hang another bag of O-Neg and get me some fibrin sealant.” He continues working with Sam and Kevin and Cas is kind of left standing there, not doing anything.

“Can I help?” He asks over the erratic beeping of the monitor and conversations between the doctors.

“You are helping,” Dean snaps back.

“Well, you’ve got more bleeders than you’ve got hands.”

Dean pauses to look up at Cas.

“Sorry,” Cas mumbles.

“No, that’s it. You get in there and take over,” he tells one of the doctors. “Novak, run to my car.”

“What?”

“Run to my car,” he looks up from the patient at Cas, “It’s where I always park it. Run fast. In the glove box there’s a green bag,” he looks back down at the patient. “Pull harder on that retractor,” he tells one of the doctors.

“I’m a surgeon-“ Cas protests.

“I’m trying to save a life, Novak. Run!” Dean yells at him.

Cas sighs and makes a break for the door, ripping off his surgical mask. He gets out into the hallway and runs as fast as he can to Dean’s car.

He finds it and opens the glove box then grabs the bag that Dean told him about. He examines it for a quick second before climbing out of the car and running back into the hospital.

He busts back into the OR.

“Nice work, Novak,” Dean tells him. “Open the bag. See the bottle with the blue label? Open it and pour it into a sterile basin and give it to Tran.”

Cas does as he’s told and pours the white, sandy-looking substance into the basin and hands it to Kevin.

Kevin grabs the tray and Dean says, “Shake it onto the wound. Right over the bleeders. A lot of it.”

Kevin begins pouring it into the patient’s body. “What is this stuff?” He asks.

“We use it in the field all the time. It’s not FDA-approved but it’s saved a lot of lives. When you don’t have time to stitch a guy up, you pour some of this on and it holds things until you get them to an OR.”

“Woah, look at that. It’s locking up the entire wound,” Kevin says and the erratic beeping of the monitor steadies out.

“Yeah, it replicates the body’s clotting process. It’s not a permanent solution but it buys us some time.”

“BP’s going up. He’s stabilizing.”

They finish the rest of the surgery and close him back up.

 

* * *

 

At the end of the day, Cas is walking out of the hospital and Dean approaches him, “Nice work today,” he says and then walks away.

Cas walks after him, angry, “’Nice work today’? Seriously?”

“I’m sorry?” Dean turns around to face him.

“’Run to my car.’ You’ve got Kevin clipping bleeders and you tell me to run to your car?”

“You know what my car looks like. Kevin doesn’t. And that-that run you took? It saved that guy’s life.”

“Yeah, well, all day you were teaching Kevin and ignoring me.”

“Kevin wants to be a trauma surgeon. You’ve already declared cardio. I didn’t do anything wrong today. I treated you like I would anyone else.” He turns and begins walking away.

Cas walks after him and shoves him, “I am not like anyone else,” his voice breaks. “’Take care, now’? What is that? What are you happy now? What are you?” He laughs, “Just a ‘choke ‘em and forget ‘em’ kind of guy?”

Dean shakes his head and sighs as he pulls a folded up piece of paper from his pocket and hands it to Cas.

Cas opens it up and reads, “’Hey there, now.’ ‘Take care, now.’ ‘Nice work, Novak.’ What is this?” He holds the paper up.

“It’s my shrink. She gave me these sentences. We actually came up with them together. They’re all three-word sentences so I could have something to say to you instead of the three words that are…” he sighs and looks at Cas, “…that are killing me.”

A tear falls from Cas’ face.

“The three words that you know I feel, but I can’t say them because it would be cruel to say them because I am no good for you,” he pauses and goes to wipe the tear from Cas’ cheek, “I don’t wanna torture you. I don’t wanna look at you longingly when I know I can’t be with you. So, yeah, I’m smiling and I’m saying ‘Take care, now.’” He shakes his head, “I’m letting you off the hook, Cas. I’m trying-I’m trying so hard to let you off the hook and I’m trying to make it right, what I did to you. Can’t you see that, Cas?”

Cas lets out a shaky exhale and presses the piece of paper against Dean’s chest, “Take care, now.”

He brushes passed Dean and walks away.

 

* * *

 

Dean takes a minute to level himself out before heading across the street to the bar where Sam is waiting for him.

The bell ringing over the door that Dean walks in grabs Sam’s attention and they smile at each other.

Sam holds a beer up and sets it at the seat next to him as Dean walks over and sits.

“Hey.”

“Hey.”

“I, uhh,” Sam begins, “I don’t really know where to start.”

Dean laughs lightly, “Yeah, we’re not really the kind of guys who are into these chick-flick kind of moments, aren’t we?”

Sam laughs, “Definitely not.”

“Yeah, and I’m not the kind of guy who can admit that he needs help and seeks out therapy but…” he gestures towards himself, “here I am.”

“Here you are,” Sam takes a drink of his beer.

“I just want to say that I’m sorry, Sammy. For everything.”

“You don’t need to be. I should be sorry. You needed me to be there for you and be on your side but I wasn’t.”

“I should’ve told you I was coming home. I should’ve told you that I wasn’t okay. I was just so wrapped up in Cas that I,” he scoffs and takes a drink of his beer. “I didn’t think about how you would be effected by it all.”

“Dean, Cas is my best friend and I care about him a lot. I was very upset when you…you know, and I didn’t handle it well. You pissed me off and then he pissed me off and I was just pissed off about the whole situation that I didn’t stop to think about how you’re doing in any of it. You’re hurt, Dean and I should’ve been there for you.”

“Well, you’re here now, right?” Dean asks hesitantly.

Sam smiles, “Yeah. I’m here now.”

They clink their beers together and take a drink.

They know that this doesn’t magically fix everything between them but it’s a pretty good start.

 

* * *

 

The following afternoon, Dean finds Cas standing at one of the nurse’s stations, talking with Sam.

Sam smiles at Dean and nods at Cas before walking away, giving them space.

It’s quiet for a few seconds between them until Cas speaks up, “How’s it going with your shrink?”

“Uh, I’m doing better. Inch by inch. You could say that things between me and Sammy are better now,” he laughs lightly. “But…progress is slow.”

Cas smiles softly at him, “I understand.”

Dean clears his throat, “Umm, it was your ceiling fan above your bed. Blades spinning like the blades of a chopper. My shrink said that that was the trigger,” he says softly, “to me, uh,” he averts his gaze from Cas, “choking you.”

“Oh.”

“Yeah,” Dean mumbles.

Their hands rest on top of the nurse’s station and Dean slowly slides his over to Cas’. They touch and Cas shies away from it, “We should probably get going.”

“Cas-“ he pleads but Cas keeps walking away from him.

That night, Cas goes home and takes a hammer to his ceiling fan, knocking it down.

 

* * *

 

The next day Dean approaches Cas, “So, I had a good session with my shrink this morning.”

Cas busies himself by reading a patient’s chart, “Did you talk about your mom?”

Dean fidgets and looks away.

“I mean, have you even seen your mom yet? Cause she lives just a few miles away and she thinks that you’re still in Iraq.”

“I-I’m planning to see her.”

“When?”

Dean stammers but can’t come up with an answer for him.

 

* * *

 

“Dr. Novak,” Dean says as he walks up behind Cas. He tugs on his arm, “I need a quick consult.” He pulls him into one of the supply closets and closes the door.

“What are you doing?”

He sighs, “I realize that the reason that I haven’t told my mom I’m back yet is because a part of me is still over there. I made a commitment to the Army that I wasn’t able to fulfill. If my unit hadn’t been destroyed, I’d still be over there. So, no wonder I can’t sleep at night or look my mother in the eye. No wonder that you and I can’t move forward, because my work over there isn’t done. And until it is, I have no business being here. So…I’ve decided to go back.”

Cas scoffs lightly, “I have to go,” and he moves to walk passed Dean and out the door until Dean grabs his arm and stops him, “Cas, come on.”

“What? What am I supposed to say, Dean?”

“I could use your support.”

“Yeah, well, you don’t have it.” He turns away and slams the door behind him.

 

* * *

 

Later on in the evening, Cas sits outside of the hospital to enjoy the setting sun and the sounds of the birds in the trees. If he closes his eyes and drowns out the sounds of nearby traffic and sirens in the distance, he can imagine himself in the middle of nowhere – a place he sometimes wishes he could vanish to.

Dean approaches him and sits next to him and Cas doesn’t even need to open his eyes to know that it’s Dean.

“It doesn’t matter how good you are. Or how hard you work,” Cas begins, “You can do all the research and you can master all the latest techniques. I mean, you can be the best…you can be the best surgeon in the world…” he scoffs, “but your patients are still gonna die. Because the next day or the next month or the next year, they’re gonna get hit by car or find a mole on their back. And there’s nothing you can do about it.” He pauses and looks over at Dean, “I don’t want you to die.”

“Okay,” he says softly and reaches out for Cas’ hand. He grabs onto it and threads his fingers between Cas’. “Come on. I gotta go see someone.” He stands up from the bench and tugs Cas along with him to his car.

Dean drives them a few miles away to a little house in a crowded neighborhood. They sit outside for a few minutes in silence and then Dean asks, “Come with me?”

Cas nods his head and steps out of the car. Dean meets him on his side and grabs his hand as they walk up to the front door.

Dean knocks and a few seconds later, a woman with long, blonde hair opens the door.

“Dean?” She asks, disbelieving.

“Hey, Mom. I’m home.” He steps inside and wraps his arms tightly around her.

She lets out a sob into Dean’s shoulder and wraps her arms around him.

Dean steps back from the hug and looks at Cas, “Mom, this is Cas. Cas, this is my mom, Mary.”

Cas shakes her hand and smiles softly.

 

* * *

 

The next morning, Cas brings Dean some coffee, “Hello, Dean.”

Dean smiles wide and takes a sip.

“Why are you so happy this morning?”

“I slept, Cas. Last night, I slept for the first time in…” he sighs, “I slept. That, and a really cute guy brought me coffee this morning and he knows just how I like it.” He smiles and takes another sip.

Cas smiles at him.

“It’s all because of you, Cas. You came with me to see my mom, and then I slept. And I slept without nightmares. That’s not a small thing, Cas,” he smiles and takes a step towards him, “That is everything.” He looks into Cas’ eyes, “I can be a better man,” he says softly, “I can be a better man for you. I hope, if you’ll let me,” he grabs onto Cas’ wrist, “I can be a better man with you.”

Cas is about to say something but Dean interrupts him, “Don’t say anything. Just think about it, okay?” He leans in to kiss him, but doesn’t close the distance, “Okay?”

Cas smiles and closes the distance between them. Dean hums into the kiss and then pulls away, “I gotta go but…think about it, okay?”

Cas smiles and watches him walk away.

 

* * *

 

Every now and then, whenever he needs a moment to himself, Cas wanders down to the room with the air vents in the basement of the hospital.

He’s sitting on one of the concrete steps and Dean walks in, “Oh, sorry. I’ll go.”

“No. Wait, Dean,” he stands up and then Dean closes the door behind him.

After a moment of silence, Cas speaks up, “There is a woman up there scared to death because the stranger that pushed her out of the way of a moving bus is about to go into surgery and he might die in there. She told me that she wishes that she gave him the chance to get to know him. To love him because they only knew each other for less than a minute,“ he pauses, “So here I am, taking the chance because I am absolutely crazy about you,” he takes a deep breath. “I love…you."

Dean smiles, “Well, I-I love you, too.”

“No! Just…I love you.” He says it like it’s something that he’s never said before and he stammers, a little upset now, “I just said ‘I love you’.” He looks at Dean like he should know why this is such a big deal for him. “Me,” he gestures towards himself, “Castiel Novak.” He stammers and sighs as he begins pacing back and forth, “You traumatized me.”

Dean takes a step towards him, “You know that I am so-I am so sorry about that, Cas.”

“No dammit. I’m not talking about the choking. It’s…it’s like, you come here and you pull out my icicle. And then you make me love you and I can’t…I mean, I don’t want to…I can’t breathe…without you, Dean.”

Dean walks towards him, “You can do this, Cas. We can do this. All you have to do is just meet me halfway. All you have to do is say yes,” he smiles. “Whenever you’re ready, I’ll be here, okay?” He turns and walks away and Cas runs after him after a minute.

He finally catches up to him and pulls him around to kiss him. “Yes!” He smiles.

Dean laughs into the kiss, “Yeah?”

Cas kisses him once more, “Yes.”

**Notes for the Chapter:**

> They're finally happy now, right? Maybe.


	15. Give Peace a Chance

**Notes for the Chapter:**

> NSFW towards the end.  
>   
> Sorry for the short chapter! Luckily, the next chapter is being posted right after I post this one.

“Dr. Winchester? A consult, please,” Cas grins at him and peels him away from his conversation with Charlie.

Dean lightly protests but follows him into the nearest on-call room. Once the door is shut, Cas shoves Dean back onto the bed and pulls his scrub top off, throwing it aside as he straddles Dean’s hips.

Dean chuckles and runs his hands up Cas’ bare skin, “You…you are incredible,” he leans up and catches Cas’ lips in a kiss.

Cas grinds his hips down on Dean’s and lets out a soft gasp.

Dean pulls back and groans, “Cas…” he kisses him once more, “you know the rules…”

Cas leans down and kisses him again, “Mmm, the rules are stupid.”

Dean wraps his fingers around Cas’ waist, stilling his movements, “So, you’re saying my shrink is stupid? Hmm?” He smiles.

“I’m saying she’s a prude. She’s prudey and…and misguided,” he leans in and capture’s Dean’s lips.

Dean moans into the kiss and rolls them over to lie Cas on the bed beneath him, “She wants us to get to know each other. She wants me to keep getting to know myself. She does not want me…burying myself in you. And if we start to have sex, I’ll bury myself in you.”

Cas waggles his eyebrows, “Then I can be the one doing the burying,” he smiles and Dean laughs and kisses him once more.

“It’s not gonna be too much longer. Do you want me to quit therapy? Hmm?”

Cas wrinkes his nose, “No,” he whines.

“Speaking of which, come on,” he stands up and pulls Cas with him. He finds Cas’ discarded scrub top and hands it to him. “We gotta go,” he kisses him, “We’ve got that appointment with Missouri.”

Cas huffs, “I still don’t understand why I’m going.”

“Because…” he kisses him, “you love me.”

Cas smiles, “Yeah, I do.”

 

* * *

 

“Uhh, he trained at Northwestern and then at Harvard,” Cas begins, “Uh, he grew up about five miles from here. Umm. Not rich. Not poor. Comfortable and well-loved by his parents, but, itching to do something more with his life, which is when he enlisted at the age of-“

“Cas, this is not a book report,” Dean chuckles.

“I’m trying to explain to Dr. Moseley that I know things about you,” he smiles at her.

“Castiel-“ Missouri tries but Cas holds a hand out to her, “Well, wait, he knows things about me, too, if that’s what you’re going to say. Because we talk. I mean, we talk all the time,” he looks over at Dean who is giving him at look of disbelief right now.

“Castiel, let me be clear. It’s not just that I want the two of you to get to know each other, it’s that I want Dean to feel comfortable with you.”

“Well, he is comfortable with me,” Cas smiles and looks over at Dean who can’t make eye contact.

Dean looks up at Missouri, “It’s okay. You can talk to him. It’s fine,” he tells her softly.

“Okay, umm, Castiel, he talks to you, he’s comfortable with you. Does he talk to you about his trauma?”

Cas looks over at Dean and Dean fidgets in his seat.

“Does he talk to you about the war? Does he talk to you about the incident between you two? The choking?”

Cas flinches slightly and leans back in his seat on the couch.

“Dean’s post-traumatic stress if fed by his avoidance of talking about anything in the war. In order to improve, to heal, he’s going to have to start talking about it, to you and to me. And my concern is if you get lost in the lust of it all, he won’t have to make a start. He won’t have any reason to. He’ll feel that he has everything he needs, until he doesn’t. So, I’m asking you…to wait.”

 

* * *

 

Cas goes back with Dean to his next session with Missouri and the atmosphere is lighter and happier than it’s ever been. They’re making jokes about a nickname that has been going around for one of the patients.

Dean and Cas both think it’s hilarious but Missouri thinks it’s dark.

“Oh, come on. I’m dark?” Cas protests, “I’m not going around choking people in their sleep!” He laughs.

“Woah! What?” Dean laughs lightly but instantly, the tension rises in the room and there’s awkward silence.

Cas clears his throat, “Too soon?”

Dean turns in his seat on the couch and faces Cas, “I’m not the guy going around choking people in their sleep.”

Cas mirrors him, “I know.”

“It was a dream. I…I can’t remember what I was dreaming about. But…I was trying to save my own life. I wasn’t trying to hurt you, Cas. I was…I was fighting for my life.”

“Okay,” Cas says softly and takes Dean’s hand into his.

“You made a start,” Missouri says, “That’s good.”

 

* * *

 

 

That night, Dean goes to Cas’ apartment for dinner.

After dinner they find themselves curled in on each other on the couch, watching some crappy reality show.

Dean tilts Cas chin up to kiss him and they makeout on the couch for a while before Dean pulls away, “I can’t hurt you again,” he caresses his cheek, “My problems, they’re real. Which makes us real. It’s makes my problems, your problems and…and I’m scared, Cas,” his voice breaks,  
I don’t want to hurt you again.”

Cas finds Dean’s eyes with his own and kisses him softly, “You can sleep on my couch, okay?”

Dean smiles lightly, “Okay,” and leans in to kiss him. He lies him back on the couch and pulls his shirt off over his head.

“Take your pants off,” Dean tells him.

Cas giggles, “Oh, now we’re having sex?”

“We talked about the thing…for a little bit. So, I think we deserve to celebrate a little bit. Plus, I’m horny and you’re hot.”

“Yeah, you’re right,” Cas smiles and pulls Dean down for another kiss. He’s able to wiggle his way out of his pants and the instant his skin is exposed, Dean leans down and takes him in his mouth.

“Fuck!”  He arches his back off the couch, “Dean. Oh my-“ he moans and rakes his fingers through Dean’s hair.

Dean pulls off with a smile and pulls his own pants down. He lies himself back on top of Cas and leans down to capture his lips with his own.

Cas adjusts himself so his hips are lined with Dean’s. He thrusts up once and Dean moans into Cas’ mouth.

“Shit, Cas…” he breathes and wraps his hand around their erections, tightly pulling on them both. They both ooze precome, giving Dean just the right amount of slick to slide his palm over them with the perfect amount of friction.

Cas exhales sharply into Dean’s mouth and wraps his arms tightly around him, pulling his body closer.

“Oh, Dean…” Cas moans, “…feel so good.”

“Yeah?” Dean breathes, lifting his head to look down into Cas’ eyes.

Cas nods his head and pulls him down for another kiss.

Dean presses kisses along Cas’ cheek and down onto his neck. He nibbles his way over to Cas’ ear, “Come for me, baby,” he whispers before latching onto Cas’ neck, biting him, hard.

Cas wraps one of his fists around Dean’s and pumps with him. His breathing gets heavier and heavier until he throws his head back in a guttural moan, screaming Dean’s name as his release paints his and Dean’s hands, along with his chest. His hand loosens his grip around his and Dean’s cocks.

“Oh, Cas…” Dean moans as he picks up the pace of his pumps. “Cas…Cas…” he chants as he spills over, spurts of come splattering on Cas’ chest, mixing with what was already there. He lets out a sigh and rests his forehead against Cas’.

After a moment, they both smile and Dean flops on the couch. It’s a tight fit and after some rearranging, Cas’ bare body pressed tightly against Dean’s front, from their chests down to their feet that are tangled in one another.

Dean wraps his arms tightly around Cas’ chest and buries his face into the back of Cas’ head.

Cas runs his hands lightly over Dean’s arms, “I love you,” he whispers softly.

Dean smiles against Cas’ hair and tilts Cas head to capture his lips in an awkward kiss, “I love you, too.”

They fall asleep on the couch, even though Cas meant to peel himself from Dean to go to his own bed, he never made it. He didn’t realize until he woke up the next morning, blanket draped over both of them. _Where the hell did that blanket come from?_

He sits up and looks over the back of the couch towards the kitchen and he finds Gabriel sitting there, sipping a cup of coffee and grinning like a smug bastard.

“Have yourself a little fun last night, there, Cas?” He grins as he takes another sip.

Cas looks down at Dean, mouth hanging wide open as he snores. He smiles to himself, “Yeah. We did.” He yawns and stretches his arms over his head.

“Just do me a favor? Make sure you don’t fall asleep naked without anything to cover you up? That’s more of either of you than I ever wanted to see.”

Cas blushes, “Sorry.”

Dean stirs awake and he sits up. He presses open mouthed kisses along Cas’ shoulders. He goes to pull Cas’ face towards him to kiss him, but Cas pulls away, “Dean. Gabriel is sitting right there,” he gestures over Dean’s shoulder.

Dean turns and sees Gabriel smiling big at him and Dean yells, “Oh my! Fucking shit, Gabriel!” He grabs at the blanket draped over his lap and tries to pull it over his chest. “What the fuck are you doing here, you freak?”

“In case you didn’t notice, Dean-o, I live here. But…” he takes a final sip, “I’m off to the hospital. I’ve got surgery in an hour.” He hops off the barstool and grabs his keys and heads out the door, slamming it behind him.

“God, he’s such a little weirdo,” Dean mumbles but continues placing kisses along Cas’ shoulder. Just as Cas goes to lie above Dean, his and Dean’s pagers buzz, beckoning them to the hospital.

They both groan but get up and get dressed quickly before they head over to the hospital, ready to dive head first into whatever gets thrown at them.


	16. Invest in Love

**Summary for the Chapter:**

> It’s impossible to describe the panic that washes over you when you’re a surgeon and your pager goes off in the middle of the night.

**Notes for the Chapter:**

> Sorry for the Gabriel/Balthazar! It's very minor, I promise!

Over at Gabriel’s place, a pager begins beeping and buzzing as well. He stirs and gets out of bed, “Please don’t be mine. Please don’t be mine,” he chants as he checks his pager. It’s not his. He smiles and hands the _other_ pager in his bedroom over to the _other_ person in his bed, “For you,” he smiles and climbs back into bed.

Balthazar cracks an eye open and check his pager. Not a second after, Gabriel’s pager begins beeping. He gets up with a smile and grabs it, “For you, darling,” he hands it to Gabriel as he lies back in bed with him.

"Ughhh," Gabriel groans as he sits up. "Come on, you," he hits Balthazar with a pillow.

They both reluctantly climb out of bed and make their way across the street to the hospital.

Once there, Dean is the first to greet them, “Balthazar, Jo is with your patient in trauma two. Gabriel, come with me,” he instructs.

“We have a 15 year old female, she fell off the roof of her house. Now I think that we need to-“

He gets interrupted by a woman, “She’s gonna be okay, right? I just need to know that she’s gonna be okay.”

“And this is her mother. Mrs. Boyd, I need to bring Dr. Milton up to speed right now, okay?”

They begin walking away and the mother follows them, “She’s never been in any accident before. She’s never even broken any bones.”

“Oh,” he turns back to Dean, “You paged me here at 4:00 am with a couple of broken bones?”

“More like 50.” Dean opens the door to a trauma room, revealing a few nurses and other doctors working on the patient. She’s got bones sticking out of her arms and her legs are bruised completely, bones sticking out every which way under the skin.

 

* * *

 

Later on that morning, Gabriel rounds the corner and sees Balthazar, “Here I brought you some coffee,” he smiles.

“Thank you,” Balthazar smiles and takes a sip, “Mmm. It’s perfect. Thank you,” he leans in and kisses him chastely.

Dean just happens to walk up at this moment, “I’m gonna pretend I didn’t just see that,” he laughs. “Anyways, when we see Cas, he’s gonna be mad. Mad at me for not paging him here. And possibly mad at you,” he points to Gabriel, “for not waking him up either. Now, I’m handling this. Do not engage him, do not provoke him. Just simply ignore him, alright?”

Gabriel scoffs, “Oh, that’s your plan? Ignore the scalpel-hungry animal?”

“Yep. Until I can come up with something better. Heads up,” he nods when he sees Cas walking down the hallway towards them. Cas makes it clearly obvious that he’s ignoring them and he keeps on walking by.

 

* * *

 

Cas, along with Dean, Gabriel, and a few other doctors follow Balthazar, the pediatric attending surgeon, on rounds.

“Dr. Novak, present,” he tells him.

Cas clears his throat and looks down at his chart, “Uh, Hillary Boyd, 15 years old. Fell off the roof of her house. Fifty-two acute fractures were diagnosed when she was admitted last night. An intricate and extremely challenging ORIF surgery was performed by Dr. Milton and Dr. Winchester this morning before rounds,” he makes it a point to glare at Dean while saying that.

“Thank you, Dr. Novak,” Dean tells him.

“If she fares well enough today, I’d like to go in tomorrow to repair her subtrochanteric fracture,” Gabriel adds.

“Hmm. Can anyone tell me the proper dosage of ceftriaxone for a pediatric patient?”

“Fifteen milligrams per kilogram per day,” Meg Masters, a newly hired resident, speaks up.

“And since she weighs 42 kilograms, that makes it 2.1 grams per day,” Cas speaks up and Dean smiles at him. Cas just rolls his eyes and walks out of the room.

 

* * *

 

Cas and Meg go back in to see Hillary and they examine her hips.

“Uh, Mr. and Mrs. Boyd?” Dean asks as he walks into the room with Gabriel.

“We thought that you should know that Hillary’s tox screens from yesterday showed signs of psilocybin in her bloodstream.”

Cas and Meg exchange concerned glances.

“What does that mean?” Mr. Boyd asks.

“Well,” Dean starts, “it means that when she fell from the roof, she was…”

“Shrooming,” Meg speaks up.

“Yeah, magic mushrooms,” Gabriel says.

The parents protest and look at their daughter. The doctors leave them to figure this one out on their own.

 

* * *

 

Later on that afternoon, Dean, Cas, Gabriel, and Meg are all operating on Hillary.

“Looks like you’ve used every piece of hardware in the hospital,” Dean jokes.

“Yeah, it makes you think twice about shrooming on a roof,” Gabriel laughs as he continues working. He drives in the final nail, “Alright, nail’s in. Everything’s tight. Let’s take a look,” he gestures for one of the nurses to pass him the fluoro machine and he turns it on. On the screen, they can see that the nails are in perfect placement.

“Fantastic,” he says and shortly after, the monitor begins beeping erratically.

They all look up at the screen.

“End-tidal CO2 just dropped from 34 to 22,” Meg says.

Gabriel sighs, “Come on, Hillary, give me a break.”

Cas looks over at another one of the monitors, “She has a new murmur,” he observes as he moves the fluoro up to her chest. “There’s an air embolus in her heart,” he says.

“Flood the filed with saline,” Gabriel instructs.

“Give me bone wax, page cardio, and set up a chest tray,” Dean tells one of the nurses.

“And put her in Trendelenburg. I can aspirate it,” Cas adds.

“No, no. We wait for cardio and we try to find the source,” Dean instructs him.

“No, it’ll take me 30 seconds. It might take cardio half an hour to get here.”

“Dr. Novak-“

“I’ve done this before! I know what I’m doing! She could arrest at any moment!”

“Dr. Novak, no! End of discussion!” Dean looks over at him and Cas shakes his head.

As the erratic beeping of the monitor continues, Cas looks over at one of the trays nearby and sees that everything he needs is right there.

“This is ridiculous,” he murmurs to Dean, “You’re wasting all this time down here when we should be dealing with the heart problem.”

“We’re following protocol. Cardio is on its way and we can find the source of the embolus this way.”

The beeping continues and Cas has finally had enough, “Screw it,” he says as he walks over to the chest tray on the other side of the patient.

“Dr. Novak, the patient is not coding and you’re not qualified to do this!” Dean says.

“Opening the left chest.”

“Woah, Cas, really?” Gabriel protests.

“Turn on the fluoro,” Cas says.

“Dr. Novak!” Dean yells.

“Will someone step on the fluoro,  or do you want me to go in blind?”

“Dr. Novak, put down that scalpel!”

Their eyes meet over their surgical masks. Neither one is willing to budge and Cas looks over at Meg.

Meg throws down her tools and walks over to turn on the fluoro for Cas.

“Thank you,” he tells her.

“Cas!” Dean yells.

Cas doesn’t listen and cuts an incision along her chest. He uses the rib spreader and cracks her chest open.

“Scissors?” He asks and a nurse hands them to him.

“Castiel!”

Cas snips and then enters a syringe, sucking the air out.

“Castiel!”

“Cardio’s here, Novak!”

“It’s done. I’m done. Air embolus is out,” he sighs and sets the syringe on the tray next to him.

 

* * *

 

Dean and Cas are scrubbing out of surgery.

“The patient was crashing.”

“She was not crashing,” Dean says as he shakes his head.

“It was a procedure that I’ve done before. I handled it and she’s fine.”

“Yeah? Well, what if she wasn’t? You could’ve lacerated her heart or cut the phrenic nerve. She could’ve died on that table. And what then? It would have been your license! All so you could prove what, exactly?”

A doctor walks by and they both stop arguing.

When he leaves, Cas continues, “Well, I did it to stabilize the patient. You were just watching her vitals drop.”

“I was waiting for a CT surgeon, who would’ve been able to take a more minimally invasive approach. I could’ve done a friggin’ thoracotomy myself if I had thought it was necessary. I’ve been around the block once or twice,” his voice raises, “I kind of know what I’m doing here!"

“I’m aware of that. I was just…”

“You just thought every-” Dean pauses as a nurse walks by, “you just thought everything would be better if you took charge.” He scoffs and shakes his head, “You know that I have to report this to Bobby, right? At a time when he is scouring this place for people to fire.”

Cas scoffs, “Well, he’s not gonna fire me.”

“Oh, of course not,” he chuckles, “because you’re invincible!”

“No. He’s not gonna fire me because the last time I did an open thoracotomy for an embolus was with him, in his OR. Only he was giving me words of encouragement, not screaming in my ear!”

Dean shakes his head and walks out of the room.

“For the record,” Meg walks up, “you rocked that in there. Winchester’s just jealous that he didn’t do it himself.”

Cas scoffs, “Shut up,” and walks out.

 

* * *

 

Later that night, Gabriel and Balthazar are cuddling on the couch in Gabriel and Cas’ apartment, watching tv and drinking beer.

Cas barges in with Dean and they’re still arguing.

“Let it go! It’s done, Dean!”

“I have every right to be mad here, Cas. You would never pull a stunt like that with another attending!”

They walk over into the kitchen and Cas pulls out a beer.

“Well, I seem to recall that Gabriel was there and he didn’t try to stop me!”

“You took advantage of me and you took advantage of our relationship.”

“The kid was drying, Dean!”

Balthazar perks up, “Woah, woah. Wait a minute. Uhh. Kid? What kid?”

“Oh, you didn’t hear?” Gabriel asks him and Balthazar shakes his head.

“Cas, here, performed an unauthorized and unnecessary thoracotomy against my orders.”

“He what?”

“I saved the patient’s life.”

“No, Cas, you went rogue,” Gabriel laughs.

“It wasn’t rogue. It was brilliant!”

“No, it wasn’t!” Dean yells, “You know what?” he holds his hands up, “I’m done. You got lucky today, Cas, and you may think that you can get away with this kind of shit, but I am telling you, one of these days, your luck is gonna run out” he turns and walks away, slamming the door behind him.

 

* * *

 

The next morning, Cas goes on his morning run and ends up at Sam and Jess’ house.

Cas flops himself on their couch and Sam comes in with coffee.

“So…Dean has told me some interesting things…” Sam begins.

Cas scoffs and sits up from the couch, “My luck will run out? It has nothing to do with luck. He’s just being an ass because I rocked that embolus and he knows it.”

Sam just sits and smiles at him.

“What?”

“He cares about you, Cas.”

“So?”

“So, maybe he’s a little bit right and I get it. You did an unauthorized procedure in an OR. I mean, you’re an amazing surgeon but if anything had gone wrong, that would’ve been your career,” he takes a sip of his coffee, “He cares about your career, Cas,” he smiles, “He’s in love with you. Trust me when I say that because I’ve never seen my brother smile or look at _anyone_ the way he smiles and looks at you.”

Cas just rolls his eyes and smiles.

Sam laughs, “Go to work and don’t cut anyone open without permission,” he stands up from the couch, “I’ll see you there.”

 

* * *

 

Later that evening, Gabriel decides to throw a little party to celebrate Balthazar’s birthday.

Cas is there, only because the party is taking place in his apartment, as well as many other doctors from the hospital. But, not Dean. Dean is still across the street at the hospital.

Cas decides to take advantage of the free booze and he indulges a little bit. He opens the door to his room to go to the bathroom and Meg walks out.

“Heya, Clarence,” she smiles.

He grimaces, “Don’t call me that.”

“Too bad,” she walks over and stands in front of him, “Let me just tell you that what you did in the OR yesterday was incredibly hot,” she trails her hand along Cas’ arm.

 Cas pulls it back slightly but Meg grabs on his wrist.

“Dr. Masters, you’re drunk and you’re in my room. You should-“

His sentence is cut off when Meg leans up and kisses him. She backs him into the nearest wall and runs her hands all over his body.

Cas protests and pushes her off of him, “I’m involved!” He says quickly. “I, umm, I’m involved with someone.” He holds his hand out to her and walks away. He only wants to see one person right now.

 

* * *

 

Cas walks up the stairs and finds Dean standing at one of the nurses’ stations.

“Surgery yesterday?” Cas begins when he walks up to Dean.

“Mhm.”

“It wasn’t just…” he sighs and gestures to himself, “it was me. Can’t you see that?”

“See what?” he asks and looks at Cas, “See what? I…I can’t just ignore what happened, Cas.”

“Okay,” he pauses, “Look, Dean, I’m sorry. I know I overstepped back there so…” he looks up into Dean’s eyes, “Come home with me?”

Dean nods his head after a moment, “Okay,” he reaches out and curls Cas’ finger in with his own as they walk towards the lounge for Dean to change into his street clothes.

**Notes for the Chapter:**

> Next chapter is when shit's gonna start going down.  
>   
> I'm predicting about 10 or so more chapters? It all depends on how I space it out cause this next arc might last a while and then I'm gonna wrap it all up in a nice and pretty bow for ya.  
>   
> If you actually know how Owen's and Cristina's story ends in Grey's, don't worry. That's not gonna happen here. uwu


	17. Author's Note

Hi everyone!  
I'm posting this just to let you all know that I am still working on this fic and have not abandoned it!  
My laptop is broken and I've been waiting to get it fixed cause it's not a cheap repair and I refuse to write fic on my phone lol. As well as life is just insanely busy for me at the moment.  
Sorry! I hope you guys can forgive me!


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